Kinugawa Anna, Takeuchi Kenji, Tamada Yudai, Kusama Taro, Sato Misuzu, Maeda Megumi, Murata Fumiko, Osaka Ken, Fukuda Haruhisa
Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.
Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.
J Periodontol. 2025 Jul;96(7):760-768. doi: 10.1002/JPER.24-0496. Epub 2025 Jan 18.
To investigate the differences in health care expenditure (HCE) due to the comorbidity status of periodontal disease (PD) and diabetes mellitus (DM).
This cohort study used health care claims and oral health screening data to identify participants with PD or DM and followed them for 1 year to assess their HCE. PD and DM were determined based on PD screening and medical claims data, respectively. The study participants were divided into four groups: participants without PD and DM (PD-/DM-), participants with PD and without DM (PD+/DM-), participants without PD and with DM (PD-/DM+), and participants with PD and DM (PD+/DM+). Covariates included age, sex, smoking status, and Charlson Comorbidity Index (CCI) score. A generalized linear model (GLM) with a gamma distribution and log link function was used to examine the association between comorbidity and annual HCE, and a two-part model was used to assess the differences in annual HCE.
In total, 790 participants (mean age: 63.1, 30.3% male) were included. Compared with the PD-/DM- group, the relative cost ratio (RCR) for the PD+/DM+, PD-/DM+, PD+/DM- groups were 1.31 (95% confidence interval [CI]: 1.06-1.62), 1.27 (95% CI: 0.99-1.64), 1.01 (95% CI: 0.89-1.14) times higher, respectively. The adjusted mean annual HCE for the PD+/DM+, PD-/DM+, PD+/DM- groups were ¥59,328 (95% CI: 14,171-104,484), ¥50,228 (95% CI: -15,801-116,256), ¥-2,162 (95% CI: -24,598-20,274) higher than the PD-/DM- group, respectively.
This study provides a significant contribution of PD to the increase in HCE, particularly in individuals with DM.
The association between periodontal disease (PD) and diabetes mellitus (DM) has commonly been described in previous literature, but the health expenditure incurred when PD and DM coexist is not clear. This study investigates the differences in health care expenditure (HCE) due to the comorbidity status of PD and DM. HCE is calculated from medical, dental, and pharmacy-dispensing expenditures from the claims data. PD was defined by periodontal pocket scores, and DM was determined based on medical records. Study participants were divided into four groups based on whether they had PD, DM, both, or neither. The results showed that people with both PD and DM had higher HCE compared with those without PD and DM. These findings may suggest the importance of cooperation between medical and dental professionals in the treatment of DM in terms of HCE.
探讨由于牙周病（PD）和糖尿病（DM）合并症状态导致的医疗保健支出（HCE）差异。
这项队列研究使用医疗保健索赔和口腔健康筛查数据来识别患有PD或DM的参与者，并对他们进行1年的随访以评估其HCE。PD和DM分别根据PD筛查和医疗索赔数据确定。研究参与者分为四组：无PD和DM的参与者（PD-/DM-）、有PD无DM的参与者（PD+/DM-）、无PD有DM的参与者（PD-/DM+）以及有PD和DM的参与者（PD+/DM+）。协变量包括年龄、性别、吸烟状况和查尔森合并症指数（CCI）评分。使用具有伽马分布和对数链接函数的广义线性模型（GLM）来检验合并症与年度HCE之间 的关联，并使用两部分模型来评估年度HCE的差异。
总共纳入了790名参与者（平均年龄：63.1岁，男性占30.3%）。与PD-/DM-组相比，PD+/DM+、PD-/DM+、PD+/DM-组的相对成本比（RCR）分别高出1.31倍（95%置信区间[CI]：1.06 - 1.62）、1.27倍（95%CI：0.99 - 1.64）、1.01倍（95%CI：0.89 - 1.14）。PD+/DM+、PD-/DM+、PD+/DM-组调整后的平均年度HCE分别比PD-/DM-组高出59328元（95%CI：14171 - 104484）、50228元（95%CI：-15801 - 116256）、-2162元（95%CI：-24598 - 20274）。
本研究表明PD对HCE增加有显著影响，尤其是在患有DM的个体中。
牙周病（PD）和糖尿病（DM）之间的关联在以往文献中已有普遍描述，但PD和DM共存时产生的健康支出尚不清楚。本研究调查了由于PD和DM合并症状态导致的医疗保健支出（HCE）差异。HCE根据索赔数据中的医疗、牙科和药房配药支出计算得出。PD由牙周袋评分定义，DM根据病历确定。研究参与者根据是否患有PD、DM、两者都有或两者都无分为四组。结果表明，与无PD和DM的人相比，患有PD和DM两者的人HCE更高。这些发现可能表明在DM治疗中，从HCE角度来看，医疗和牙科专业人员合作的重要性。
