Trends in health care expenditure in U.S. adults with diabetes: 2002-2011. Diabetes Care 2015 Oct;38(10):1844-51
Date
07/24/2015Pubmed ID
26203060Pubmed Central ID
PMC4580605DOI
10.2337/dc15-0369Scopus ID
2-s2.0-84960945662 (requires institutional sign-in at Scopus site) 62 CitationsAbstract
OBJECTIVE: Direct medical cost of diabetes in the U.S. has been estimated to be 2.3 times higher relative to individuals without diabetes. This study examines trends in health care expenditures by expenditure category in U.S. adults with diabetes between 2002 and 2011.
RESEARCH DESIGN AND METHODS: We analyzed 10 years of data representing a weighted population of 189,013,514 U.S. adults aged ≥18 years from the Medical Expenditure Panel Survey. We used a novel two-part model to estimate adjusted mean and incremental medical expenditures by diabetes status, while adjusting for demographics, comorbidities, and time.
RESULTS: Relative to individuals without diabetes ($5,058 [95% CI 4,949-5,166]), individuals with diabetes ($12,180 [11,775-12,586]) had more than double the unadjusted mean direct expenditures over the 10-year period. After adjustment for confounders, individuals with diabetes had $2,558 (2,266-2,849) significantly higher direct incremental expenditures compared with those without diabetes. For individuals with diabetes, inpatient expenditures rose initially from $4,014 in 2002/2003 to $4,183 in 2004/2005 and then decreased continuously to $3,443 in 2010/2011, while rising steadily for individuals without diabetes. The estimated unadjusted total direct expenditures for individuals with diabetes were $218.6 billion/year and adjusted total incremental expenditures were approximately $46 billion/year.
CONCLUSIONS: Our findings show that compared with individuals without diabetes, individuals with diabetes had significantly higher health expenditures from 2002 to 2011 and the bulk of the expenditures came from hospital inpatient and prescription expenditures.
Author List
Ozieh MN, Bishu KG, Dismuke CE, Egede LEAuthors
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of WisconsinMukoso Nwamaka Ozieh MD Assistant Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Comorbidity
Cost of Illness
Delivery of Health Care
Diabetes Mellitus
Female
Health Expenditures
Humans
Insurance, Health
Male
Middle Aged
Patient Acceptance of Health Care
Retrospective Studies
United States
Young Adult
