Direct medical costs of diabetes mellitus in the year of mortality and year preceding the year of mortality

Diabetes Obes Metab. 2018 Jun;20(6):1470-1478. doi: 10.1111/dom.13253. Epub 2018 Mar 11.

Abstract

Aim: To report the health resource use and estimate the direct medical costs among patients with diabetes mellitus (DM) in the year of mortality and the year preceding the year of mortality.

Materials and methods: We analysed data from a population-based, retrospective cohort study including all adults with a DM diagnosis in Hong Kong between 2009 and 2013, and who died between January 1, 2010 and December 31, 2013. The annual direct medical costs in the year of mortality and the year preceding the year of mortality were determined by summing the costs of health services utilized within the respective year. The costs were analysed by gender, the presence of comorbidities, diabetic complications and primary cause of death.

Results: A total of 10 649 patients met the eligibility criteria for analysis. On average, the direct medical costs in the year of death were 1.947 times higher than those in the year before death. Men and women with DM incurred similar costs in the year preceding the year of mortality and in the mortality year. Patients with any diabetic complications incurred greater costs in the year of mortality and the year before mortality than those without.

Conclusions: This analysis provides new evidence on incorporating additional direct medical costs in the mortality year, and refining the structure of total cost estimates for use in costing and cost-effectiveness analyses of interventions for DM.

Keywords: cohort study; cost-effectiveness; database research; primary care; type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / economics*
  • Diabetes Mellitus, Type 1 / mortality
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / economics*
  • Diabetes Mellitus, Type 2 / mortality
  • Direct Service Costs
  • Facilities and Services Utilization
  • Female
  • Health Expenditures
  • Health Services / economics
  • Health Services / statistics & numerical data
  • Hong Kong / epidemiology
  • Hospitalization / economics
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Retrospective Studies
  • Time Factors