PMID- 31098887
OWN - NLM
STAT- MEDLINE
DCOM- 20200205
LR  - 20200225
IS  - 1618-7601 (Electronic)
IS  - 1618-7598 (Linking)
VI  - 20
IP  - 7
DP  - 2019 Sep
TI  - Costs of people with diabetes in relation to average glucose control: an 
      empirical approach controlling for year of onset cohorts.
PG  - 989-1000
LID - 10.1007/s10198-019-01072-z [doi]
AB  - OBJECTIVE: To estimate the impact of glycaemic control and time since diabetes 
      diagnosis on care costs incurred by people with type 2 diabetes mellitus (T2DM). 
      RESEARCH DESIGN AND METHODS: Random-effects linear regression models were run to 
      test the impact of average glucose control (HbA1c) and time since diabetes 
      diagnosis on total care spending in people with T2DM, adjusting for year of onset 
      and other covariates. Two datasets were linked, Vektis (healthcare costs 
      reimbursed by the Dutch mandatory health insurance) and Zodiac (clinical and 
      sociodemographic data). The sample includes 22,612 observations, grouped in 5653 
      individuals from the Northern part of the Netherlands, covering 4 years 
      (2008-2011). RESULTS: A 1% point increase in HbA1c is associated with a 2.2% 
      higher total care costs. However, when treatment modality is included, the 
      results are modified. A 1% point increase (11 mol/mol) in HbA1c is significantly 
      associated with 3.4% higher total care costs for individuals without 
      glucose-lowering treatment. Being treated with insulin is significantly 
      associated with an increase in costs of 30-38% for every additional percentage 
      point of HbA1c, depending on the covariates included. Without controlling for 
      year of onset, an additional year of diabetes duration relates to 2.6% higher 
      care costs, while this is 4.9% controlling for year of onset. The effect of HbA1c 
      and diabetes duration differs between types of costs. CONCLUSION: HbA1c, insulin 
      treatment and diabetes duration are the main drivers of increasing care costs. 
      The results signal the relevance of controlling for HbA1c together with treatment 
      modality, diabetes duration and year of diagnosis effects.
FAU - Rodriguez-Sanchez, Beatriz
AU  - Rodriguez-Sanchez B
AUID- ORCID: 0000-0002-6146-068X
AD  - Department of Economic Analysis and Finance, Faculty of Law and Social Sciences, 
      University of Castilla la Mancha, Cobertizo de San Pedro Martir s/n, 45071, 
      Toledo, Spain. Beatriz.RSanchez@uclm.es.
FAU - Feenstra, Talitha L
AU  - Feenstra TL
AD  - Department of Epidemiology, University Medical Centrum of Groningen, Groningen, 
      The Netherlands.
FAU - Bilo, Henk J G
AU  - Bilo HJG
AD  - Department of Internal Medicine-Management, University Medical Centrum of 
      Groningen, Groningen, The Netherlands.
FAU - Alessie, Rob J M
AU  - Alessie RJM
AD  - Department of Economics, Econometrics and Finance, University of Groningen, 
      Groningen, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20190516
PL  - Germany
TA  - Eur J Health Econ
JT  - The European journal of health economics : HEPAC : health economics in prevention 
      and care
JID - 101134867
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Aged
MH  - *Blood Glucose/analysis
MH  - Diabetes Mellitus, Type 2/*economics/therapy
MH  - Female
MH  - *Health Expenditures/trends
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Netherlands
MH  - Prospective Studies
MH  - Regression Analysis
OTO - NOTNLM
OT  - Average glucose control
OT  - Care costs
OT  - Diabetes duration
OT  - Diabetes treatment
OT  - Type 2 diabetes mellitus
OT  - Year of onset cohorts
EDAT- 2019/05/18 06:00
MHDA- 2020/02/06 06:00
CRDT- 2019/05/18 06:00
PHST- 2018/11/12 00:00 [received]
PHST- 2019/05/07 00:00 [accepted]
PHST- 2019/05/18 06:00 [pubmed]
PHST- 2020/02/06 06:00 [medline]
PHST- 2019/05/18 06:00 [entrez]
AID - 10.1007/s10198-019-01072-z [pii]
AID - 10.1007/s10198-019-01072-z [doi]
PST - ppublish
SO  - Eur J Health Econ. 2019 Sep;20(7):989-1000. doi: 10.1007/s10198-019-01072-z. Epub 
      2019 May 16.