Rubin R J, Altman W M, Mendelson D N
Lewin-VHI, Inc., Fairfax, Virginia 22031.
J Clin Endocrinol Metab. 1994 Apr;78(4):809A-809F. doi: 10.1210/jcem.78.4.8157701.
The purpose of this report is to estimate diabetes prevalence and annual health care costs for people with diabetes in 1992, compare average annual costs for diabetics and nondiabetics, and estimate the portion of total U.S. health care expenditures incurred by people with the disease. Data from the 1987 National Medical Expenditure Survey were used to estimate diabetes prevalence and health care expenditures for diabetics in 1992. Diabetics were identified based on self-reports of a physician diagnosis of diabetes, a history of taking diabetic medications, or an encounter with the health care system specifically related to diabetes. Identified diabetics were classified as confirmed if they had a history of taking diabetic medications, had a diabetes-specific encounter with the health care system, or purchased diabetic equipment. Estimates of diabetes prevalence and health care expenditures were calculated separately for identified and confirmed diabetics using the National Medical Expenditure Survey database. Total health care expenditures included costs associated with inpatient hospital care, outpatient hospital care, office visits to a physician or other provider, emergency room visits, home health care, prescription drugs, dental care, and durable medical equipment purchases. We estimate that percapita annual health care expenditures in 1992 were more than three times greater for diabetics ($9,493) than for nondiabetics ($2,604). Percapita expenditures for confirmed diabetics ($11,157) were more than four times greater than for nondiabetics. In 1992, diabetics constituted 4.5% of the U.S. population but accounted for 14.6% of total U.S. health care expenditures ($105 billion). Confirmed diabetics constituted 3.1% of the U.S. population but accounted for 11.9% of total U.S. health care expenditures ($85 billion). This study found that health care expenditures for people with diabetes constituted about one in seven health care dollars spent in 1992. Health care reform and insurers should take note of these findings and structure benefit packages to promote care likely to reduce the costs of caring for diabetics.
本报告旨在估算1992年糖尿病患者的糖尿病患病率及年度医疗保健费用，比较糖尿病患者与非糖尿病患者的年均费用，并估算美国该疾病患者所产生的医疗保健总支出的占比。利用1987年国家医疗支出调查的数据来估算1992年糖尿病患者的糖尿病患病率及医疗保健支出。根据医生诊断糖尿病的自我报告、服用糖尿病药物的病史或与糖尿病专门相关的医疗保健系统接触情况来确定糖尿病患者。若已确定的糖尿病患者有服用糖尿病药物的病史、与医疗保健系统有特定的糖尿病相关接触或购买了糖尿病设备，则被归类为确诊患者。利用国家医疗支出调查数据库分别计算已确定和确诊糖尿病患者的糖尿病患病率及医疗保健支出估算值。医疗保健总支出包括与住院医院护理、门诊医院护理、看医生或其他医疗服务提供者、急诊室就诊、家庭医疗保健、处方药、牙科护理以及耐用医疗设备购买相关的费用。我们估计，1992年糖尿病患者的人均年度医疗保健支出（9493美元）是非糖尿病患者（2604美元）的三倍多。确诊糖尿病患者的人均支出（11157美元）是非糖尿病患者的四倍多。1992年，糖尿病患者占美国人口的4.5%，但占美国医疗保健总支出（1050亿美元）的14.6%。确诊糖尿病患者占美国人口的3.1%，但占美国医疗保健总支出（850亿美元）的11.9%。本研究发现，1992年糖尿病患者的医疗保健支出约占医疗保健总支出的七分之一。医疗保健改革和保险公司应注意这些发现，并构建福利套餐以促进可能降低糖尿病患者护理成本的护理。
