The relative burden of diabetes complications on healthcare costs: The population-based CINECA-SID ARNO Diabetes Observatory.
BACKGROUND AND AIMS
In the present population-based study, we aimed to describe the per patient annual healthcare cost of people with diabetes in 2007-2012, to assess the relative burden of diabetes complications and other potential determinants on healthcare costs in the 2012 cohort, and to describe and analyse the determinants of the cost of incident cases diagnosed in 2012.


METHODS AND RESULTS
We analysed data from a retrospective cohort of residents in four Italian areas that were served by Local Health Units participating in the ARNO Observatory. Per patient annual healthcare costs (Euros) were estimated as the sum of all the resources supplied during that year (drugs, outpatient care, and hospitalisations). The mean per patient annual healthcare cost increased from €2752 in 2007 to €3191 in 2010, before decreasing to €2791 in 2012. The largest component of these costs was represented by hospitalisations (around €1550, on average; 51.7% of total cost), followed by outpatient care (€422; 14.6%) and drugs (€973; 33.7%). In 2012, the most relevant cost determinants were chronic diabetes complications, with an additional cost due to nephropathy/end stage renal disease (€4683), amputations (€5042), lower extremity revascularization (€4808), and cerebrovascular diseases (€3861). Costs associated with incidence cases were higher than those associated with prevalent.


CONCLUSION
The present study provides evidence on the excess of healthcare costs due to diabetes complications in both prevalent and incident cases.
['Pagano|E|E|', 'De Rosa|M|M|', 'Rossi|E|E|', 'Cinconze|E|E|', 'Marchesini|G|G|', 'Miccoli|R|R|', 'Vaccaro|O|O|', 'Bonora|E|E|', 'Bruno|G|G|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D000553:Ambulatory Care D002648:Child D002675:Child, Preschool D003695:Delivery of Health Care D048909:Diabetes Complications D005260:Female D017048:Health Care Costs D017721:Hospital Costs D006760:Hospitalization D006801:Humans D007004:Hypoglycemic Agents D015994:Incidence D007223:Infant D007231:Infant, Newborn D007558:Italy D008297:Male D008875:Middle Aged D018803:Models, Economic D015995:Prevalence D012189:Retrospective Studies D013997:Time Factors D055815:Young Adult
Diabetes complications Cost Health care delivery