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Heterogeneity in the costs of type 1 diabetes in a developing country: what are the determining factors?

BACKGROUND AND AIMS: Regional differences in the clinical care of Type 1 diabetes (T1D) in Brazil have been recently described. This study aimed to estimate the costs of T1D from the public health care system’s perspective across the regions of Brazil and to determine the components that influence t...

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Autores principales: Cobas, Roberta Arnoldi, Bosi Ferraz, Marcos, Matheus, Alessandra Saldanha de Mattos, Tannus, Lucianne Righeti Monteiro, Silva, Aline Tiemi Kano, de Araujo, Luiz Antonio, Negrato, Carlos Antonio, Dib, Sérgio Atala, Brito Gomes, Marilia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3879422/
https://www.ncbi.nlm.nih.gov/pubmed/24373627
http://dx.doi.org/10.1186/1758-5996-5-83
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author Cobas, Roberta Arnoldi
Bosi Ferraz, Marcos
Matheus, Alessandra Saldanha de Mattos
Tannus, Lucianne Righeti Monteiro
Silva, Aline Tiemi Kano
de Araujo, Luiz Antonio
Negrato, Carlos Antonio
Dib, Sérgio Atala
Brito Gomes, Marilia
author_facet Cobas, Roberta Arnoldi
Bosi Ferraz, Marcos
Matheus, Alessandra Saldanha de Mattos
Tannus, Lucianne Righeti Monteiro
Silva, Aline Tiemi Kano
de Araujo, Luiz Antonio
Negrato, Carlos Antonio
Dib, Sérgio Atala
Brito Gomes, Marilia
author_sort Cobas, Roberta Arnoldi
collection PubMed
description BACKGROUND AND AIMS: Regional differences in the clinical care of Type 1 diabetes (T1D) in Brazil have been recently described. This study aimed to estimate the costs of T1D from the public health care system’s perspective across the regions of Brazil and to determine the components that influence these costs. METHODS: This was a retrospective, cross-sectional and nationwide multicenter study conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. The study included 3,180 T1D subjects receiving healthcare from the National Brazilian Healthcare System (NBHCS) with a follow-up of at least one year. The direct medical costs were derived from the costs of medications, supplies, examinations, visits to the center, medical procedures and hospitalizations that occurred during the previous year. Clinical and demographic factors that determined the differences in the cost across four geographic regions (southeast, south, north/northeast and mid-west) were investigated. RESULTS: The per capita mean annual direct medical costs of T1D in US$ were 1,466.36, 1,252.83, 1,148.09 and 1,396.30 in southeast, south, north/northeast and mid-west regions, respectively. The costs of T1D in the southeast region were higher compared to south (p < 0.001) and north/northeast regions (p = < 0.001), but not to the mid-west (p = 0.146) region. The frequency of self-monitoring of blood glucose (SMBG) was different across the regions as well as the daily number of SMBG, use of insulin pumps or basal or prandial insulin analogs. Age, ethnicity, duration of diabetes, level of care, socioeconomic status and the prevalence of chronic diabetic complications differed among the regions. In a regression model the determinants of the costs were the presence of microvascular diabetes-related complications (p < 0.001), higher economic status (p < 0.001), and being from the southeast region (p < 0.001). CONCLUSIONS: The present data reinforce the regional differences in the costs of T1D and in the socioeconomic profile and health care provided to the patients with T1D in specialized public centers in Brazil. Both factors influenced directly the costs of T1D and should be considered for discussing future health policies.
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spelling pubmed-38794222014-01-04 Heterogeneity in the costs of type 1 diabetes in a developing country: what are the determining factors? Cobas, Roberta Arnoldi Bosi Ferraz, Marcos Matheus, Alessandra Saldanha de Mattos Tannus, Lucianne Righeti Monteiro Silva, Aline Tiemi Kano de Araujo, Luiz Antonio Negrato, Carlos Antonio Dib, Sérgio Atala Brito Gomes, Marilia Diabetol Metab Syndr Research BACKGROUND AND AIMS: Regional differences in the clinical care of Type 1 diabetes (T1D) in Brazil have been recently described. This study aimed to estimate the costs of T1D from the public health care system’s perspective across the regions of Brazil and to determine the components that influence these costs. METHODS: This was a retrospective, cross-sectional and nationwide multicenter study conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. The study included 3,180 T1D subjects receiving healthcare from the National Brazilian Healthcare System (NBHCS) with a follow-up of at least one year. The direct medical costs were derived from the costs of medications, supplies, examinations, visits to the center, medical procedures and hospitalizations that occurred during the previous year. Clinical and demographic factors that determined the differences in the cost across four geographic regions (southeast, south, north/northeast and mid-west) were investigated. RESULTS: The per capita mean annual direct medical costs of T1D in US$ were 1,466.36, 1,252.83, 1,148.09 and 1,396.30 in southeast, south, north/northeast and mid-west regions, respectively. The costs of T1D in the southeast region were higher compared to south (p < 0.001) and north/northeast regions (p = < 0.001), but not to the mid-west (p = 0.146) region. The frequency of self-monitoring of blood glucose (SMBG) was different across the regions as well as the daily number of SMBG, use of insulin pumps or basal or prandial insulin analogs. Age, ethnicity, duration of diabetes, level of care, socioeconomic status and the prevalence of chronic diabetic complications differed among the regions. In a regression model the determinants of the costs were the presence of microvascular diabetes-related complications (p < 0.001), higher economic status (p < 0.001), and being from the southeast region (p < 0.001). CONCLUSIONS: The present data reinforce the regional differences in the costs of T1D and in the socioeconomic profile and health care provided to the patients with T1D in specialized public centers in Brazil. Both factors influenced directly the costs of T1D and should be considered for discussing future health policies. BioMed Central 2013-12-27 /pmc/articles/PMC3879422/ /pubmed/24373627 http://dx.doi.org/10.1186/1758-5996-5-83 Text en Copyright © 2013 Cobas et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Cobas, Roberta Arnoldi
Bosi Ferraz, Marcos
Matheus, Alessandra Saldanha de Mattos
Tannus, Lucianne Righeti Monteiro
Silva, Aline Tiemi Kano
de Araujo, Luiz Antonio
Negrato, Carlos Antonio
Dib, Sérgio Atala
Brito Gomes, Marilia
Heterogeneity in the costs of type 1 diabetes in a developing country: what are the determining factors?
title Heterogeneity in the costs of type 1 diabetes in a developing country: what are the determining factors?
title_full Heterogeneity in the costs of type 1 diabetes in a developing country: what are the determining factors?
title_fullStr Heterogeneity in the costs of type 1 diabetes in a developing country: what are the determining factors?
title_full_unstemmed Heterogeneity in the costs of type 1 diabetes in a developing country: what are the determining factors?
title_short Heterogeneity in the costs of type 1 diabetes in a developing country: what are the determining factors?
title_sort heterogeneity in the costs of type 1 diabetes in a developing country: what are the determining factors?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3879422/
https://www.ncbi.nlm.nih.gov/pubmed/24373627
http://dx.doi.org/10.1186/1758-5996-5-83
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