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Cost of hospital treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) compared to the non-diabetes population: a detailed economic evaluation

OBJECTIVES: Other than age, diabetes is the largest contributor to overall healthcare costs and reduced life expectancy in Europe. This paper aims to more exactly quantify the net impact of diabetes on different aspects of healthcare provision in hospitals in England, building on previous work that...

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Autores principales: Stedman, Mike, Lunt, Mark, Davies, Mark, Livingston, Mark, Duff, Christopher, Fryer, Anthony, Anderson, Simon George, Gadsby, Roger, Gibson, Martin, Rayman, Gerry, Heald, Adrian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223153/
https://www.ncbi.nlm.nih.gov/pubmed/32376746
http://dx.doi.org/10.1136/bmjopen-2019-033231
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author Stedman, Mike
Lunt, Mark
Davies, Mark
Livingston, Mark
Duff, Christopher
Fryer, Anthony
Anderson, Simon George
Gadsby, Roger
Gibson, Martin
Rayman, Gerry
Heald, Adrian
author_facet Stedman, Mike
Lunt, Mark
Davies, Mark
Livingston, Mark
Duff, Christopher
Fryer, Anthony
Anderson, Simon George
Gadsby, Roger
Gibson, Martin
Rayman, Gerry
Heald, Adrian
author_sort Stedman, Mike
collection PubMed
description OBJECTIVES: Other than age, diabetes is the largest contributor to overall healthcare costs and reduced life expectancy in Europe. This paper aims to more exactly quantify the net impact of diabetes on different aspects of healthcare provision in hospitals in England, building on previous work that looked at the determinants of outcome in type 1 diabetes (T1DM) and type 2 diabetes (T2DM). SETTING: NHS Digital Hospital Episode Statistics (HES) in England was combined with the National Diabetes Audit (NDA) to provide the total number in practice of people with T1DM/T2DM. OUTCOME MEASURES: We compared differences between T1DM/T2DM and non-diabetes individuals in relation to hospital activity and associated cost. RESULTS: The study captured 90% of hospital activity and £36 billion/year of hospital spend. The NDA Register showed that out of a total reported population of 58 million, 2.9 million (6.5%) had T2DM and 240 000 (0.6%) had T1DM. Bed-day analysis showed 17% of beds are occupied by T2DM and 3% by T1DM. The overall cost of hospital care for people with diabetes is £5.5 billion/year. Once the normally expected costs including the older age of T2DM hospital attenders are allowed for this fell to £3.0 billion/year or 8% of the total captured secondary care costs. This equates to £560/non-diabetes person compared with £3280/person with T1DM and £1686/person with T2DM. For people with diabetes, the net excess impact on non-elective/emergency work is £1.2 billion with additional estimated diabetes-related accident & emergency attendances at 440 000 costing the NHS £70 million/year. T1DM individuals required five times more secondary care support than non-diabetes individuals. T2DM individuals, even allowing for the age, require twice as much support as non-diabetes individuals. CONCLUSIONS: This analysis shows that additional cost of provision of hospital services due to their diabetes comorbidities is £3 billion above that for non-diabetes, and that within this, T1DM has three times as much cost impact as T2DM. We suggest that supporting patients in diabetes management may significantly reduce hospital activity.
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spelling pubmed-72231532020-05-15 Cost of hospital treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) compared to the non-diabetes population: a detailed economic evaluation Stedman, Mike Lunt, Mark Davies, Mark Livingston, Mark Duff, Christopher Fryer, Anthony Anderson, Simon George Gadsby, Roger Gibson, Martin Rayman, Gerry Heald, Adrian BMJ Open Diabetes and Endocrinology OBJECTIVES: Other than age, diabetes is the largest contributor to overall healthcare costs and reduced life expectancy in Europe. This paper aims to more exactly quantify the net impact of diabetes on different aspects of healthcare provision in hospitals in England, building on previous work that looked at the determinants of outcome in type 1 diabetes (T1DM) and type 2 diabetes (T2DM). SETTING: NHS Digital Hospital Episode Statistics (HES) in England was combined with the National Diabetes Audit (NDA) to provide the total number in practice of people with T1DM/T2DM. OUTCOME MEASURES: We compared differences between T1DM/T2DM and non-diabetes individuals in relation to hospital activity and associated cost. RESULTS: The study captured 90% of hospital activity and £36 billion/year of hospital spend. The NDA Register showed that out of a total reported population of 58 million, 2.9 million (6.5%) had T2DM and 240 000 (0.6%) had T1DM. Bed-day analysis showed 17% of beds are occupied by T2DM and 3% by T1DM. The overall cost of hospital care for people with diabetes is £5.5 billion/year. Once the normally expected costs including the older age of T2DM hospital attenders are allowed for this fell to £3.0 billion/year or 8% of the total captured secondary care costs. This equates to £560/non-diabetes person compared with £3280/person with T1DM and £1686/person with T2DM. For people with diabetes, the net excess impact on non-elective/emergency work is £1.2 billion with additional estimated diabetes-related accident & emergency attendances at 440 000 costing the NHS £70 million/year. T1DM individuals required five times more secondary care support than non-diabetes individuals. T2DM individuals, even allowing for the age, require twice as much support as non-diabetes individuals. CONCLUSIONS: This analysis shows that additional cost of provision of hospital services due to their diabetes comorbidities is £3 billion above that for non-diabetes, and that within this, T1DM has three times as much cost impact as T2DM. We suggest that supporting patients in diabetes management may significantly reduce hospital activity. BMJ Publishing Group 2020-05-05 /pmc/articles/PMC7223153/ /pubmed/32376746 http://dx.doi.org/10.1136/bmjopen-2019-033231 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Diabetes and Endocrinology
Stedman, Mike
Lunt, Mark
Davies, Mark
Livingston, Mark
Duff, Christopher
Fryer, Anthony
Anderson, Simon George
Gadsby, Roger
Gibson, Martin
Rayman, Gerry
Heald, Adrian
Cost of hospital treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) compared to the non-diabetes population: a detailed economic evaluation
title Cost of hospital treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) compared to the non-diabetes population: a detailed economic evaluation
title_full Cost of hospital treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) compared to the non-diabetes population: a detailed economic evaluation
title_fullStr Cost of hospital treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) compared to the non-diabetes population: a detailed economic evaluation
title_full_unstemmed Cost of hospital treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) compared to the non-diabetes population: a detailed economic evaluation
title_short Cost of hospital treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) compared to the non-diabetes population: a detailed economic evaluation
title_sort cost of hospital treatment of type 1 diabetes (t1dm) and type 2 diabetes (t2dm) compared to the non-diabetes population: a detailed economic evaluation
topic Diabetes and Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223153/
https://www.ncbi.nlm.nih.gov/pubmed/32376746
http://dx.doi.org/10.1136/bmjopen-2019-033231
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