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Annual health care resource utilization and cost among type 2 diabetes patients with newly recognized chronic kidney disease within a large U.S. administrative claims database
BACKGROUND: Chronic kidney disease (CKD) is one of the most common complications of type 2 diabetes mellitus (T2D) and results in considerable economic burden. Current studies describing cost and health care resource utilization (HCRU) in T2D patients with CKD in real-world data are few. Even more s...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Academy of Managed Care Pharmacy
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10391265/ https://www.ncbi.nlm.nih.gov/pubmed/33251992 http://dx.doi.org/10.18553/jmcp.2020.26.12.1506 |
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author | Folkerts, Kerstin Petruski-Ivleva, Natalia Kelly, Amanda Fried, Linda Blankenburg, Michael Gay, Alain Kovesdy, Csaba P |
author_facet | Folkerts, Kerstin Petruski-Ivleva, Natalia Kelly, Amanda Fried, Linda Blankenburg, Michael Gay, Alain Kovesdy, Csaba P |
author_sort | Folkerts, Kerstin |
collection | PubMed |
description | BACKGROUND: Chronic kidney disease (CKD) is one of the most common complications of type 2 diabetes mellitus (T2D) and results in considerable economic burden. Current studies describing cost and health care resource utilization (HCRU) in T2D patients with CKD in real-world data are few. Even more scarce is evidence that takes into account disease severity and other comorbidities. OBJECTIVES: To (a) describe T2D patients with CKD identified in U.S. administrative claims data using laboratory test results for kidney function that are considered the gold standard criteria for kidney disease diagnosis and (b) estimate the annual HCRU and costs among these patients, overall and by disease severity and comorbidity subgroup. METHODS: Optum CDM data between the years 2008 and 2017 were used to identify T2D patients with newly recognized CKD, using laboratory test results for estimated glomerular filtration rate (eGFR) or urine albumin-to-creatinine ratio (UACR). The study estimated annualized total, inpatient, outpatient, and pharmacy costs and the number of outpatient, inpatient, and emergency room visits in the first year after CKD identification. Analyses were stratified by prevalent anemia, heart failure (HF), resistant hypertension, and by CKD stages. RESULTS: T2D patients with newly recognized CKD (n = 106,369) had a high prevalence of cardiovascular comorbidities and incurred on average $24,029 of total cost per person per year in the first year after CKD identification. Patients with HF and anemia incurred on average $41,951 and $31,127 of total annual cost, respectively. Patients identified at stage 5 CKD incurred on average $110,210 of total annual cost and had roughly a 7-fold higher annual inpatient hospitalization rate compared with patients identified at stage 1 CKD. CONCLUSIONS: Administrative claims data linked to laboratory results provide an opportunity to identify CKD patients using the gold standard criteria from clinical practice, minimizing potential misclassification of patients. Identified CKD patients, particularly those with HF, anemia, and more advanced CKD stage, incur high HCRU and cost. Better monitoring, earlier CKD diagnosis, and interventions that are effective in halting or slowing the progression of CKD, as well as at managing comorbid conditions, could be effective means to reduce the economic burden of CKD in T2D. |
format | Online Article Text |
id | pubmed-10391265 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Academy of Managed Care Pharmacy |
record_format | MEDLINE/PubMed |
spelling | pubmed-103912652023-08-02 Annual health care resource utilization and cost among type 2 diabetes patients with newly recognized chronic kidney disease within a large U.S. administrative claims database Folkerts, Kerstin Petruski-Ivleva, Natalia Kelly, Amanda Fried, Linda Blankenburg, Michael Gay, Alain Kovesdy, Csaba P J Manag Care Spec Pharm Research BACKGROUND: Chronic kidney disease (CKD) is one of the most common complications of type 2 diabetes mellitus (T2D) and results in considerable economic burden. Current studies describing cost and health care resource utilization (HCRU) in T2D patients with CKD in real-world data are few. Even more scarce is evidence that takes into account disease severity and other comorbidities. OBJECTIVES: To (a) describe T2D patients with CKD identified in U.S. administrative claims data using laboratory test results for kidney function that are considered the gold standard criteria for kidney disease diagnosis and (b) estimate the annual HCRU and costs among these patients, overall and by disease severity and comorbidity subgroup. METHODS: Optum CDM data between the years 2008 and 2017 were used to identify T2D patients with newly recognized CKD, using laboratory test results for estimated glomerular filtration rate (eGFR) or urine albumin-to-creatinine ratio (UACR). The study estimated annualized total, inpatient, outpatient, and pharmacy costs and the number of outpatient, inpatient, and emergency room visits in the first year after CKD identification. Analyses were stratified by prevalent anemia, heart failure (HF), resistant hypertension, and by CKD stages. RESULTS: T2D patients with newly recognized CKD (n = 106,369) had a high prevalence of cardiovascular comorbidities and incurred on average $24,029 of total cost per person per year in the first year after CKD identification. Patients with HF and anemia incurred on average $41,951 and $31,127 of total annual cost, respectively. Patients identified at stage 5 CKD incurred on average $110,210 of total annual cost and had roughly a 7-fold higher annual inpatient hospitalization rate compared with patients identified at stage 1 CKD. CONCLUSIONS: Administrative claims data linked to laboratory results provide an opportunity to identify CKD patients using the gold standard criteria from clinical practice, minimizing potential misclassification of patients. Identified CKD patients, particularly those with HF, anemia, and more advanced CKD stage, incur high HCRU and cost. Better monitoring, earlier CKD diagnosis, and interventions that are effective in halting or slowing the progression of CKD, as well as at managing comorbid conditions, could be effective means to reduce the economic burden of CKD in T2D. Academy of Managed Care Pharmacy 2020-12 /pmc/articles/PMC10391265/ /pubmed/33251992 http://dx.doi.org/10.18553/jmcp.2020.26.12.1506 Text en Copyright © 2020, Academy of Managed Care Pharmacy. All rights reserved. https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use and redistribution provided that the original author and source are credited. |
spellingShingle | Research Folkerts, Kerstin Petruski-Ivleva, Natalia Kelly, Amanda Fried, Linda Blankenburg, Michael Gay, Alain Kovesdy, Csaba P Annual health care resource utilization and cost among type 2 diabetes patients with newly recognized chronic kidney disease within a large U.S. administrative claims database |
title | Annual health care resource utilization and cost among type 2 diabetes patients with newly recognized chronic kidney disease within a large U.S. administrative claims database |
title_full | Annual health care resource utilization and cost among type 2 diabetes patients with newly recognized chronic kidney disease within a large U.S. administrative claims database |
title_fullStr | Annual health care resource utilization and cost among type 2 diabetes patients with newly recognized chronic kidney disease within a large U.S. administrative claims database |
title_full_unstemmed | Annual health care resource utilization and cost among type 2 diabetes patients with newly recognized chronic kidney disease within a large U.S. administrative claims database |
title_short | Annual health care resource utilization and cost among type 2 diabetes patients with newly recognized chronic kidney disease within a large U.S. administrative claims database |
title_sort | annual health care resource utilization and cost among type 2 diabetes patients with newly recognized chronic kidney disease within a large u.s. administrative claims database |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10391265/ https://www.ncbi.nlm.nih.gov/pubmed/33251992 http://dx.doi.org/10.18553/jmcp.2020.26.12.1506 |
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