Health service utilization and related costs attributable to diabetes

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Date
2018-08-28
Authors
O'Neill, Kate N.
McHugh, Sheena M.
Tracey, Marsha L.
Fitzgerald, Anthony P.
Kearney, Patricia M.
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John Wiley & Sons, Inc.
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Abstract
Aims: To estimate the health service use and direct healthcare costs attributable to diabetes using best available data and methods. Methods: A nationally representative sample of adults aged ≥50 years was analysed (n=8107). Health service use in the previous 12 months included the number of general practitioner visits, outpatient department visits, hospital admissions, and accident and emergency department attendances. Multivariable negative binomial regression was used to estimate the associations between diabetes and frequency of visits. Average marginal effects were applied to unit costs for each health service and extrapolated to the total population, calculating the incremental costs associated with diabetes. Results: The prevalence of diabetes was 8.0% (95% CI 7.4, 8.6). In fully adjusted models, diabetes was associated with additional health service use. Compared to those without diabetes, people with diabetes have, on average, 1.49 (95% CI 1.10, 1.88) additional general practitioner visits annually. Diabetes was associated with an 87% increase in outpatient visits, a 52% increase in hospital admissions and a 33% increase in accident and emergency department attendances (P<0.001). The incremental cost of this additional service use, nationally, is an estimated €88,894,421 annually, with hospital admissions accounting for 67% of these costs. Conclusion: Using robust methods, we identified substantially increased service use attributable to diabetes across the health system. Our findings highlight the urgent need to invest in the prevention and management of diabetes.
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Keywords
Diabetes , Prevention and management of diabetes , Increased service use , Health service
Citation
O'Neill, K. N., McHugh, S. M., Tracey, M. L., Fitzgerald, A. P. and Kearney, P. M. (2018) 'Health service utilization and related costs attributable to diabetes', Diabetic Medicine. doi:doi:10.1111/dme.13806
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© 2018, John Wiley & Sons Inc. This is the peer reviewed version of the following article: O'Neill, K. N., McHugh, S. M., Tracey, M. L., Fitzgerald, A. P. and Kearney, P. M. (2018) 'Health service utilization and related costs attributable to diabetes', Diabetic Medicine. doi:10.1111/dme.13806, which has been published in final form at https://doi.org/10.1111/dme.13806. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.