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Annual direct medical costs associated with diabetes‐related complications in the event year and in subsequent years in Hong Kong
Author(s) -
Jiao F.,
Wong C. K. H.,
Tang S. C. W.,
Fung C. S. C.,
Tan K. C. B.,
McGhee S.,
Gangwani R.,
Lam C. L. K.
Publication year - 2017
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13416
Subject(s) - medicine , diabetes mellitus , stroke (engine) , myocardial infarction , cohort , disease , complication , indirect costs , emergency medicine , kidney disease , surgery , mechanical engineering , accounting , engineering , business , endocrinology
Aim To develop models to estimate the direct medical costs associated with diabetes‐related complications in the event year and in subsequent years. Methods The public direct medical costs associated with 13 diabetes‐related complications were estimated among a cohort of 128 353 people with diabetes over 5 years. Private direct medical costs were estimated from a cross‐sectional survey among 1825 people with diabetes. We used panel data regression with fixed effects to investigate the impact of each complication on direct medical costs in the event year and subsequent years, adjusting for age and co‐existing complications. Results The expected annual public direct medical cost for the baseline case was US $1,521 (95% CI 1,518 to 1,525) or a 65‐year‐old person with diabetes without complications. A new lower limb ulcer was associated with the biggest increase, with a multiplier of 9.38 (95% CI 8.49 to 10.37). New end‐stage renal disease and stroke increased the annual medical cost by 5.23 (95% CI 4.70 to 5.82) and 5.94 (95% CI 5.79 to 6.10) times, respectively. History of acute myocardial infarction, congestive heart failure, stroke, end‐stage renal disease and lower limb ulcer increased the cost by 2–3 times. The expected annual private direct medical cost of the baseline case was US $187 (95% CI 135 to 258) for a 65‐year‐old man without complications. Heart disease, stroke, sight‐threatening diabetic retinopathy and end‐stage renal disease increased the private medical costs by 1.5 to 2.5 times. Conclusions Wide variations in direct medical cost in event year and subsequent years across different major complications were observed. Input of these data would be essential for economic evaluations of diabetes management programmes.