The Lewin Group, Falls Church, Virginia 22042, USA.
Popul Health Manag. 2009 Apr;12(2):103-10. doi: 10.1089/pop.2009.12203.
The objective was to estimate the economic costs of diagnosed type 1 (T1DM) and type 2 (T2DM) diabetes mellitus in the United States in 2007. Medical claims were analyzed to estimate the proportion of diagnosed diabetes cases and excess medical costs by diabetes type. Indirect costs associated with T1DM and T2DM were estimated by using findings from the literature on diagnosed diabetes, as well as differences in health per case of T1DM and T2DM. This study builds on the Cost of Diabetes Model developed for the American Diabetes Association to estimate the economic burden of diagnosed diabetes. T1DM accounts for an estimated 5.7% (1.0 million) of the 17.5 million people with diagnosed diabetes. Approximately $14.9 billion (8.6%) of the economic burden of diagnosed diabetes is associated with T1DM, including medical costs of $10.5 billion and indirect costs of $4.4 billion. Costs associated with T2DM are $159.5 billion, including medical costs of $105.7 billion and indirect costs of $53.8 billion. The economic burden per case of diabetes is greater for T1DM than for T2DM, and the difference increases with age. The prevalence of T2DM is significantly greater than the prevalence of T1DM, so T2DM is responsible for most of the economic burden of diabetes. Estimates for T1DM are sensitive to the criteria used to identify people with diabetes using claims data; estimates for T2DM are relatively stable. Improved coding of diabetes type in medical claims and identification of diabetes type in survey data could lead to more precise estimates of the economic burden by diabetes type.
本研究旨在估算 2007 年美国已确诊 1 型(T1DM)和 2 型(T2DM)糖尿病患者的经济成本。通过医疗索赔分析,估算了各型糖尿病的确诊病例比例和超额医疗费用。通过对已确诊糖尿病患者的文献研究结果以及 T1DM 和 T2DM 每例患者健康状况的差异,估算了 T1DM 和 T2DM 相关的间接成本。本研究基于美国糖尿病协会开发的糖尿病成本模型,旨在估算已确诊糖尿病的经济负担。T1DM 占已确诊 1750 万糖尿病患者的 5.7%(100 万例)。约 149 亿美元(8.6%)的已确诊糖尿病经济负担与 T1DM 相关,其中医疗费用为 105 亿美元,间接费用为 44 亿美元。T2DM 的相关成本为 1595 亿美元,其中医疗费用为 1057 亿美元,间接费用为 538 亿美元。T1DM 的单位病例经济负担大于 T2DM,且这种差异随年龄增加而增大。T2DM 的发病率显著高于 T1DM,因此 T2DM 是导致糖尿病经济负担的主要原因。使用索赔数据确定糖尿病患者时所采用的标准对 T1DM 的估算结果较为敏感,而 T2DM 的估算结果相对稳定。医疗索赔中对糖尿病类型的编码改进以及调查数据中对糖尿病类型的识别可使糖尿病类型的经济负担估算结果更为准确。