Kim Kibum, Crook Jacob, Lu Chao-Chin, Nyman Heather, Sarker Jyotirmoy, Nelson Richard, LaFleur Joanne
Department of Pharmacy Systems, Outcomes and Policy, University of Illinois Chicago, Chicago, IL.
Department of Pharmacotherapy, University of Utah, Salt Lake City, UT.
Kidney Med. 2024 Jul 18;6(9):100873. doi: 10.1016/j.xkme.2024.100873. eCollection 2024 Sep.
In the United States, diabetic kidney disease (DKD) affects about one-third of individuals with type 2 diabetes, causing significant economic burdens on the health care system and affecting patients' quality of life.
The aim of the study was to quantify the burden of care in patients at different stages of DKD and to monitor shifts in healthcare costs throughout these stages.
This study used data from the Veterans Affairs National database, focusing on US veterans diagnosed with DKD between January 2016 and March 2022. Aggregated all-cause health care costs per month were summarized using descriptive statistics. We used a generalized linear model to calculate the cost of DKD patent care based on the stages, dialysis phase, and kidney replacement therapy.
The cohort of 685,288 patients with DKD was predominantly male (96.51%), White (74.42%), and non-Hispanic (93.54%). The mean (SD) per-patient per-month costs were $1,597 ($3,178), $1,772 ($4,269), $2,857 ($13,072), $3,722 ($12,134), $5,505 ($14,639), and $6,999 ($16,901) for stages 1, 2, 3a, 3b, 4 and 5 respectively. The average monthly expenditure for patients receiving long-term dialysis was $12,299. Costs peaked sharply during the first month of kidney replacement therapy at $38,359 but subsequently decreased to $6,636 after 1 year.
The economic implications of DKD are profound, emphasizing the need for efficient early detection and disease management strategies. Preventing patients from progressing to advanced DKD stage will minimize the economic repercussions of DKD and will assist health care systems in optimizing resource allocation.
在美国，糖尿病肾病（DKD）影响着约三分之一的2型糖尿病患者，给医疗保健系统带来巨大经济负担，并影响患者的生活质量。
本研究的目的是量化DKD不同阶段患者的护理负担，并监测这些阶段医疗费用的变化。
本研究使用了退伍军人事务部国家数据库的数据，重点关注2016年1月至2022年3月期间被诊断为DKD的美国退伍军人。每月汇总的全因医疗费用使用描述性统计进行总结。我们使用广义线性模型根据阶段、透析阶段和肾脏替代疗法计算DKD患者护理的费用。
685288例DKD患者队列中，男性占主导（96.51%），白人（74.42%），非西班牙裔（93.54%）。1、2、3a、3b、4和5期患者每月人均费用分别为1597美元（3178美元）、1772美元（4269美元）、2857美元（13072美元）、3722美元（12134美元）、5505美元（14639美元）和6999美元（16901美元）。接受长期透析患者的平均每月支出为12299美元。肾脏替代疗法第一个月的费用急剧峰值为38359美元，但1年后降至6636美元。
DKD的经济影响深远，强调了高效早期检测和疾病管理策略的必要性。防止患者进展到DKD晚期将使DKD的经济影响最小化，并有助于医疗保健系统优化资源分配。
