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Diabetes cost

Canada: Diabetics cost twice as much as non-diabetics

The study captured healthcare costs of almost three million people from 2004-2012 using patient-specific health administrative data
Females living with diabetes cost the system C$9,731 more than a non-diabetic female and males cost C$10,315 more

Each person living with diabetes requires care that costs the Canadian healthcare system an average of C$16,000 over eight years, compared to C$6,000 in average health-care costs for people who don't live with diabetes, according to a study ‘Impact of diabetes on healthcare costs in a population-based cohort: a cost analysis’ published in Diabetes Medicine.

Laura Rosella

"Diabetes is one of the greatest public health and health system challenges of the 21st century because it's among the most costly health conditions to manage," said Dr Laura Rosella, lead author, assistant professor at the University of Toronto's Dalla Lana School of Public Health, adjunct scientist at Institute for Clinical Evaluative Sciences (ICES) and scientist at Public Health Ontario. Rosella noted Canadian cost estimates directly attributable to diabetes were limited before this study.

The study, the most comprehensive Canadian analysis of healthcare costs related to diabetes to date with a sample size of almost three million people, was funded by the Canadian Institutes of Health Research. It captured healthcare costs of almost three million people from 2004-2012 using patient-specific health administrative data, including hospitalizations, emergency visits, surgery, dialysis, clinic visits, prescription medications, laboratory, rehabilitation and home care and medical devices.

Researchers estimated annual attributable per-person costs, dollars spent directly as a result of diabetes-related care, as the difference in health-care costs between diabetes cases and matched non-diabetes controls.

Using data from the ICES, they found that the average per-person health care spending for diabetes cases is more than twice that of non-diabetes controls and results in billions of dollars of health care related costs annually. Over the eight-year study, females living with diabetes cost the system C$9,731 more than a non-diabetic female and males cost C$10,315 more. Roughly C$4,000 of these costs related to diabetes were incurred in the first year after diagnosis.

"We found that the older you are, the substantially higher the cost, and, even after adjusting for other complicated medical conditions and socioeconomic status, attributable diabetes costs are mostly due to hospitalisations, physician visits, prescription medications and medical devices," said Rosella.

"For the 3.4 million Canadians living with diabetes, it decreases quality and length of life, and is a leading cause of kidney failure, lower limb amputation and blindness among adults," said Dr Jan Hux, chief science officer at the Canadian Diabetes Association. "Looking beyond the impact on individuals, this study documents the heavy and potentially unsustainable burden the condition poses to the healthcare system."

Rosella, among many other researchers, predicts that diabetes prevalence will increase as a result of a population aging, rising obesity, sedentary lifestyles and decreased mortality rates among people with diabetes.

"It is critical to comprehensively estimate health-care costs specifically due to diabetes in order to appropriately allocate health resources and more importantly to determine the economic benefit of diabetes prevention strategies, that is, the health-care costs that could be averted if diabetes prevention efforts were to be scaled up," said Rosella.

The excess healthcare costs attributable to diabetes are substantial and pose a significant clinical and public health challenge. This burden is an important consideration for decision-makers, particularly given increasing concern over the sustainability of the healthcare system, aging population structure and increasing prevalence of diabetic risk factors, such as obesity.

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