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A cohort of children with type 1 diabetes in Greece: predictors of direct costs of care
Author(s) -
Karachaliou Feneli,
Athanasakis Konstantinos,
Tsentidis Charalabos,
Soldatou Alexandra,
Simatos George,
Kyriopoulos John,
Michalakos Stefanos,
Karavanaki Kyriaki
Publication year - 2017
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12408
Subject(s) - medicine , glycemic , regimen , glycated hemoglobin , confidence interval , cohort , insulin pump , type 1 diabetes , pediatrics , diabetes mellitus , outpatient clinic , insulin , type 2 diabetes , endocrinology
Aim To examine the predictors of direct costs of pediatric type 1 diabetes ( T1D ) in a hospital‐based outpatient clinic in Greece. Methods The outpatient records of 89 children and adolescents (mean age: 12.05 ± 5.15 y) with T1D followed in the Second Department of Pediatrics, University of Athens Medical School, were analyzed. Results The mean ± SD diabetes duration was 4.9 ± 3.88 y (range: 0.25‐17) and glycated hemoglobin ( HbA1c ) was 8.2 ± 1.09% (66 ± 11.9 mmol/mol). A total of 80% of patients were on multiple daily injections regimen, 10% on pump therapy, and 10% on conventional regimen. Total direct costs per patient‐year (ppy) were estimated at €2.712 [95% confidence interval ( CI ): 2.468‐2.956]. Supply costs accounted for 73.7% of total costs and were the highest for pump therapy ( P < .001). Multivariate linear regression analysis showed that costs were significantly higher for children (1) on multiple daily injections or pump therapy (r = 0.364, P < .001), (2) of older age (r = 0.25, P < .001) and (3) higher daily insulin dose (r = 0.46, P < .001). Patients on pump therapy had significantly higher costs €5.538 (95% CI 4480‐6597) compared with patients on multiple daily injections €2.447 (95% CI 2320‐2574) and conventional regimen €1.978.5 (95% CI 1682‐2275) ( P = .0001). Patients on pump therapy had better glycemic control compared with all other patients [ HbA1c (mean ± SD): 7.2% ± 1.0 vs 8.3% ±1.5, P = .039]. Conclusion The total T1D cost in this cohort of Greek children was €2712 ppy. The main factor that predicted direct cost was the use of pump. However, pump therapy was associated with better glycaemic control, which may decrease the risk of total long‐term diabetes care cost.