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Direct Medical Costs In The Year Of Mortality For Patients With Diabetes: A Population-Based Patient-Level Analysis
OBJECTIVES: Estimates of direct medical cost associated with diabetes-related complications in the event and subsequent years have been quantified but costs in the mortality year have never been reported. This study aimed to estimate the direct medical costs of patients with diabetes mellitus (DM) i...
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| Published in: | Value in health 2017-10, Vol.20 (9), p.A497-A498 |
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| container_end_page | A498 |
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| container_title | Value in health |
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| creator | Wong, CK Jiao, F Tang, EH Fung, CS Lam, CL |
| description | OBJECTIVES: Estimates of direct medical cost associated with diabetes-related complications in the event and subsequent years have been quantified but costs in the mortality year have never been reported. This study aimed to estimate the direct medical costs of patients with diabetes mellitus (DM) in the year of mortality and the year before mortality. METHODS: We analyzed a population-based, retrospective cohort study including all adults with DM managed under public sector between 2009 and 2013 in Hong Kong. Individuals died between January 1, 2010 and December 31,2013 were included in analysis. Annual direct medical costs in year of mortality and the year before mortality per patient were analyzed by gender, the presence of co-morbidities, the presence of diabetic complications (heart disease, stroke, diabetic nephropathy, or diabetic retinopathy), and primary cause of death. RESULTS: A total of 6,919 met the eligibility criteria for analysis. The commonest cause of death among DM patients was neoplasms (2261, 32.7%), followed by diseases of respiratory system (1725, 24.9%) and diseases of circulatory system (1113, 16.1%). On average, the direct medical costs in the year of death were 2.075 times higher than those in the year before death (US$23,256.1 vs US$11,205.2, p |
| doi_str_mv | 10.1016/j.jval.2017.08.561 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2113726024</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2113726024</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1151-2829ac7f8be55739ca11901527673b04cefb2f122c69f36b3b28643261bfaf523</originalsourceid><addsrcrecordid>eNo1kMFKAzEQhoMoWKsv4CngeddMssnueqvVaqGlPVTEU8imCc2yNjVJC317t1RPMzAfw_9_CN0DyYGAeGzz9qC6nBIoc1LlXMAFGgCnRVaUjF32O6mrjBHg1-gmxpYQIhjlAxRfXDA64blZO606PPYxRTzd4tXG4C-jAl5YPPchqc6lI574gJcqObPtqU-XNvjFqcYkE5_wCC_9bt_1V7_NnlU06380m5mD6fBoq7pjdPEWXVnVRXP3N4foY_K6Gr9ns8XbdDyaZRqAQ0YrWitd2qoxnJes1gqg7hvQUpSsIYU2tqEWKNWitkw0rKGVKBgV0FhlOWVD9HD-uwv-Z29ikq3fhz5ElBSAlVQQWvQUPVM6-BiDsXIX3LcKRwlEnuTKVp7kypNcSSrZy2W_HEZtCg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2113726024</pqid></control><display><type>article</type><title>Direct Medical Costs In The Year Of Mortality For Patients With Diabetes: A Population-Based Patient-Level Analysis</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>ScienceDirect Freedom Collection</source><creator>Wong, CK ; Jiao, F ; Tang, EH ; Fung, CS ; Lam, CL</creator><creatorcontrib>Wong, CK ; Jiao, F ; Tang, EH ; Fung, CS ; Lam, CL</creatorcontrib><description>OBJECTIVES: Estimates of direct medical cost associated with diabetes-related complications in the event and subsequent years have been quantified but costs in the mortality year have never been reported. This study aimed to estimate the direct medical costs of patients with diabetes mellitus (DM) in the year of mortality and the year before mortality. METHODS: We analyzed a population-based, retrospective cohort study including all adults with DM managed under public sector between 2009 and 2013 in Hong Kong. Individuals died between January 1, 2010 and December 31,2013 were included in analysis. Annual direct medical costs in year of mortality and the year before mortality per patient were analyzed by gender, the presence of co-morbidities, the presence of diabetic complications (heart disease, stroke, diabetic nephropathy, or diabetic retinopathy), and primary cause of death. RESULTS: A total of 6,919 met the eligibility criteria for analysis. The commonest cause of death among DM patients was neoplasms (2261, 32.7%), followed by diseases of respiratory system (1725, 24.9%) and diseases of circulatory system (1113, 16.1%). On average, the direct medical costs in the year of death were 2.075 times higher than those in the year before death (US$23,256.1 vs US$11,205.2, p<0.001). Female patients had slightly higher costs in the year of mortality (US$23,337.2 vs US$23,172.8) and the year before mortality (US$11,261.5 vs US$11,147.3) than male patients. The increase in Charlson index was associated with greater costs in the mortality year. Patients with any diabetic complications had greater costs in the year of mortality (US$25,909.3 vs US$20,625.2) and before mortality (US$13,218.7 vs US$9,208.5) than those without. CONCLUSIONS: This analysis provided new evidence on incorporating additional direct medical cost in the mortality year, and refining total cost estimation for studies on costing and cost-effectiveness analyses of health interventions for diabetes.</description><identifier>ISSN: 1098-3015</identifier><identifier>EISSN: 1524-4733</identifier><identifier>DOI: 10.1016/j.jval.2017.08.561</identifier><language>eng</language><publisher>Lawrenceville: Elsevier Science Ltd</publisher><subject>Analysis ; Autoimmune diseases ; Cardiovascular diseases ; Circulatory system ; Cohort analysis ; Complications ; Coronary artery disease ; Cost analysis ; Costing ; Death ; Death & dying ; Diabetes ; Diabetes mellitus ; Diabetic nephropathy ; Diabetic retinopathy ; Health care expenditures ; Heart diseases ; Medical treatment ; Mortality ; Nephropathy ; Population studies ; Public sector ; Respiratory system ; Retinopathy ; Tumors ; Year before death</subject><ispartof>Value in health, 2017-10, Vol.20 (9), p.A497-A498</ispartof><rights>Copyright Elsevier Science Ltd. Oct/Nov 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902,30976</link.rule.ids></links><search><creatorcontrib>Wong, CK</creatorcontrib><creatorcontrib>Jiao, F</creatorcontrib><creatorcontrib>Tang, EH</creatorcontrib><creatorcontrib>Fung, CS</creatorcontrib><creatorcontrib>Lam, CL</creatorcontrib><title>Direct Medical Costs In The Year Of Mortality For Patients With Diabetes: A Population-Based Patient-Level Analysis</title><title>Value in health</title><description>OBJECTIVES: Estimates of direct medical cost associated with diabetes-related complications in the event and subsequent years have been quantified but costs in the mortality year have never been reported. This study aimed to estimate the direct medical costs of patients with diabetes mellitus (DM) in the year of mortality and the year before mortality. METHODS: We analyzed a population-based, retrospective cohort study including all adults with DM managed under public sector between 2009 and 2013 in Hong Kong. Individuals died between January 1, 2010 and December 31,2013 were included in analysis. Annual direct medical costs in year of mortality and the year before mortality per patient were analyzed by gender, the presence of co-morbidities, the presence of diabetic complications (heart disease, stroke, diabetic nephropathy, or diabetic retinopathy), and primary cause of death. RESULTS: A total of 6,919 met the eligibility criteria for analysis. The commonest cause of death among DM patients was neoplasms (2261, 32.7%), followed by diseases of respiratory system (1725, 24.9%) and diseases of circulatory system (1113, 16.1%). On average, the direct medical costs in the year of death were 2.075 times higher than those in the year before death (US$23,256.1 vs US$11,205.2, p<0.001). Female patients had slightly higher costs in the year of mortality (US$23,337.2 vs US$23,172.8) and the year before mortality (US$11,261.5 vs US$11,147.3) than male patients. The increase in Charlson index was associated with greater costs in the mortality year. Patients with any diabetic complications had greater costs in the year of mortality (US$25,909.3 vs US$20,625.2) and before mortality (US$13,218.7 vs US$9,208.5) than those without. CONCLUSIONS: This analysis provided new evidence on incorporating additional direct medical cost in the mortality year, and refining total cost estimation for studies on costing and cost-effectiveness analyses of health interventions for diabetes.</description><subject>Analysis</subject><subject>Autoimmune diseases</subject><subject>Cardiovascular diseases</subject><subject>Circulatory system</subject><subject>Cohort analysis</subject><subject>Complications</subject><subject>Coronary artery disease</subject><subject>Cost analysis</subject><subject>Costing</subject><subject>Death</subject><subject>Death & dying</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetic nephropathy</subject><subject>Diabetic retinopathy</subject><subject>Health care expenditures</subject><subject>Heart diseases</subject><subject>Medical treatment</subject><subject>Mortality</subject><subject>Nephropathy</subject><subject>Population studies</subject><subject>Public sector</subject><subject>Respiratory system</subject><subject>Retinopathy</subject><subject>Tumors</subject><subject>Year before death</subject><issn>1098-3015</issn><issn>1524-4733</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNo1kMFKAzEQhoMoWKsv4CngeddMssnueqvVaqGlPVTEU8imCc2yNjVJC317t1RPMzAfw_9_CN0DyYGAeGzz9qC6nBIoc1LlXMAFGgCnRVaUjF32O6mrjBHg1-gmxpYQIhjlAxRfXDA64blZO606PPYxRTzd4tXG4C-jAl5YPPchqc6lI574gJcqObPtqU-XNvjFqcYkE5_wCC_9bt_1V7_NnlU06380m5mD6fBoq7pjdPEWXVnVRXP3N4foY_K6Gr9ns8XbdDyaZRqAQ0YrWitd2qoxnJes1gqg7hvQUpSsIYU2tqEWKNWitkw0rKGVKBgV0FhlOWVD9HD-uwv-Z29ikq3fhz5ElBSAlVQQWvQUPVM6-BiDsXIX3LcKRwlEnuTKVp7kypNcSSrZy2W_HEZtCg</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Wong, CK</creator><creator>Jiao, F</creator><creator>Tang, EH</creator><creator>Fung, CS</creator><creator>Lam, CL</creator><general>Elsevier Science Ltd</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope></search><sort><creationdate>201710</creationdate><title>Direct Medical Costs In The Year Of Mortality For Patients With Diabetes: A Population-Based Patient-Level Analysis</title><author>Wong, CK ; Jiao, F ; Tang, EH ; Fung, CS ; Lam, CL</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1151-2829ac7f8be55739ca11901527673b04cefb2f122c69f36b3b28643261bfaf523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Analysis</topic><topic>Autoimmune diseases</topic><topic>Cardiovascular diseases</topic><topic>Circulatory system</topic><topic>Cohort analysis</topic><topic>Complications</topic><topic>Coronary artery disease</topic><topic>Cost analysis</topic><topic>Costing</topic><topic>Death</topic><topic>Death & dying</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetic nephropathy</topic><topic>Diabetic retinopathy</topic><topic>Health care expenditures</topic><topic>Heart diseases</topic><topic>Medical treatment</topic><topic>Mortality</topic><topic>Nephropathy</topic><topic>Population studies</topic><topic>Public sector</topic><topic>Respiratory system</topic><topic>Retinopathy</topic><topic>Tumors</topic><topic>Year before death</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wong, CK</creatorcontrib><creatorcontrib>Jiao, F</creatorcontrib><creatorcontrib>Tang, EH</creatorcontrib><creatorcontrib>Fung, CS</creatorcontrib><creatorcontrib>Lam, CL</creatorcontrib><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><jtitle>Value in health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wong, CK</au><au>Jiao, F</au><au>Tang, EH</au><au>Fung, CS</au><au>Lam, CL</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Direct Medical Costs In The Year Of Mortality For Patients With Diabetes: A Population-Based Patient-Level Analysis</atitle><jtitle>Value in health</jtitle><date>2017-10</date><risdate>2017</risdate><volume>20</volume><issue>9</issue><spage>A497</spage><epage>A498</epage><pages>A497-A498</pages><issn>1098-3015</issn><eissn>1524-4733</eissn><abstract>OBJECTIVES: Estimates of direct medical cost associated with diabetes-related complications in the event and subsequent years have been quantified but costs in the mortality year have never been reported. This study aimed to estimate the direct medical costs of patients with diabetes mellitus (DM) in the year of mortality and the year before mortality. METHODS: We analyzed a population-based, retrospective cohort study including all adults with DM managed under public sector between 2009 and 2013 in Hong Kong. Individuals died between January 1, 2010 and December 31,2013 were included in analysis. Annual direct medical costs in year of mortality and the year before mortality per patient were analyzed by gender, the presence of co-morbidities, the presence of diabetic complications (heart disease, stroke, diabetic nephropathy, or diabetic retinopathy), and primary cause of death. RESULTS: A total of 6,919 met the eligibility criteria for analysis. The commonest cause of death among DM patients was neoplasms (2261, 32.7%), followed by diseases of respiratory system (1725, 24.9%) and diseases of circulatory system (1113, 16.1%). On average, the direct medical costs in the year of death were 2.075 times higher than those in the year before death (US$23,256.1 vs US$11,205.2, p<0.001). Female patients had slightly higher costs in the year of mortality (US$23,337.2 vs US$23,172.8) and the year before mortality (US$11,261.5 vs US$11,147.3) than male patients. The increase in Charlson index was associated with greater costs in the mortality year. Patients with any diabetic complications had greater costs in the year of mortality (US$25,909.3 vs US$20,625.2) and before mortality (US$13,218.7 vs US$9,208.5) than those without. CONCLUSIONS: This analysis provided new evidence on incorporating additional direct medical cost in the mortality year, and refining total cost estimation for studies on costing and cost-effectiveness analyses of health interventions for diabetes.</abstract><cop>Lawrenceville</cop><pub>Elsevier Science Ltd</pub><doi>10.1016/j.jval.2017.08.561</doi><oa>free_for_read</oa></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); ScienceDirect Freedom Collection |
| subjects | Analysis Autoimmune diseases Cardiovascular diseases Circulatory system Cohort analysis Complications Coronary artery disease Cost analysis Costing Death Death & dying Diabetes Diabetes mellitus Diabetic nephropathy Diabetic retinopathy Health care expenditures Heart diseases Medical treatment Mortality Nephropathy Population studies Public sector Respiratory system Retinopathy Tumors Year before death |
| title | Direct Medical Costs In The Year Of Mortality For Patients With Diabetes: A Population-Based Patient-Level Analysis |
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