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Age-specific direct health care costs attributable to diabetesin a Swedish population: a register-based analysis
Linköping University, Department of Medicine and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Primary Health Care Centres.
Linköping University, Department of Medicine and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
2008 (English)In: Diabetic Medicine, ISSN 0742-3071, Vol. 25, no 6, 732-737 p.Article in journal (Refereed) Published
Abstract [en]

Aims: The aim of this population-based study was to explore the age-specific additional direct healthcare cost for patients with diabetes compared with the non-diabetic population.

Methods: In 1999-2005, patients with diabetes in the Swedish county of Östergötland (n = 20 876) were identified from an administrative database. Cost data on the healthcare expenditure in primary healthcare, out-patient hospital care and in-patient care for the entire county population (n = ∼415 000) in 2005 were extracted from a cost per patient (CPP) database, which includes information on all utilized healthcare resources in the county. Data on drug sales were obtained from the Swedish Prescribed Drug Register.

Results: The cost per person was 1.8 times higher in patients with diabetes than in the non-diabetic population, 7.7 times higher in children and 1.3 times higher in subjects aged > 75 years. The additional cost per person for diabetes was €1971; €3930 and €1367, respectively, for children and subjects aged > 75 years. The proportion of total additional diabetes costs attributable to in-patient care increased with age from 25 to 50%; in-patient care was the most expensive component at all ages except in children, for whom visiting a specialist was most expensive. The diabetes-related segment of the total healthcare cost was 6.6%, increasing from 2.0% in children to 10.3% in the age group 65-74 years, declining to 6.2% in the oldest age group.

Conclusions: The direct medical cost of diabetes varies considerably by age. Knowledge about the influence of age on healthcare costs to society will be important in future planning of diabetes management.

Place, publisher, year, edition, pages
2008. Vol. 25, no 6, 732-737 p.
Keyword [en]
Diabetes, Economics, Healthcare delivery, Prevalence, Registers
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-12760DOI: 10.1111/j.1464-5491.2008.02444.xOAI: oai:DiVA.org:liu-12760DiVA: diva2:16978
Available from: 2007-11-06 Created: 2007-11-06 Last updated: 2009-08-21
In thesis
1. A Data-Rich World: Population‐based registers in healthcare research
Open this publication in new window or tab >>A Data-Rich World: Population‐based registers in healthcare research
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Advances and integration of information and communication technologies into healthcare systems offer new opportunities to improve public health worldwide. In Sweden, there are already unique possibilities for epidemiological research from registers because of a long tradition of centralized data collection into population-based registers and their allowance for linkage. The growing efficiency of automated digital storage provides growing volumes of archived data that increases the potential of analyses further.

The purpose of this thesis can be divided into two parallel themes: illustrations and discussions of the use and usefulness of population-based registers on the one hand, and specific research questions in epidemiology and healthcare research on the other. The research questions are addressed in separate papers.

From the Swedish Cancer Registry, 25 years of incidence data on testicular cancer was extracted for a large cohort. Record linkage to survey data on serum cholesterol showed a highly significant positive association, suggesting that elevated serum cholesterol concentration is a risk factor for testicular cancer. Since the finding is the first of its kind and because of wide confidence intervals further studies are needed to confirm the association.

Östergötland County council’s administra-tive database (the Care Data Warehouse in Östergötland (CDWÖ)) provided data for preva-lence estimations of four common chronic diseases.

The prevalence rate agreed very well with previous estimates for diabetes and fairly well with those for asthma. For hypertension and chronic obstructive pulmonary disease, the observed rates were lower than previous prevalence estimates. Data on several consecutive years covering all healthcare levels are needed to achieve valid prevalence estimates.

CDWÖ data was also used to analyse the impact of diabetes on the prevalence of ischemic heart disease. Women had higher diabetes/non-diabetes prevalence rate ratios across all ages. The relative gender difference remained up to the age of 65 years and thereafter decreased considerably.

The age-specific direct healthcare cost of diabetes was explored using data from the CDWÖ, the county council’s Cost Per Patient database and the Swedish Prescribed Drug Register. The cost per patient and the relative magnitude of different cost components varied considerably by age, which is important to consider in the future planning of diabetes management.

The Cancer Registry was established mainly as a basis for epidemiological surveillance and research, exemplified in this thesis by a study on testicular cancer. In contrast, the newly established and planned healthcare databases in different Swedish counties are mainly for managerial purposes. As is shown in this thesis, these new databases may also be used to address problems in epidemiology and healthcare research.

Place, publisher, year, edition, pages
Institutionen för medicin och hälsa, 2007. 76 p.
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 404Linköping Dissertations on Health and Society, ISSN 1651-1646 ; 10
Keyword
chronic disease, demographic factors, healthcare costs, hospitalization, incidence, registers, primary healthcare, prevalence
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-10207 (URN)978‐91‐85895‐96‐0 (ISBN)
Public defence
2007-11-09, Elsa Brändströmsalen, Campus US, Linköpings universitet, Linköping, 10:00 (English)
Opponent
Supervisors
Available from: 2007-11-06 Created: 2007-11-06 Last updated: 2009-05-19

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Wiréhn, Ann-BrittAndersson, AgnetaÖstgren, Carl JohanCarstensen, John

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