The impact of diabetes-related complications on healthcare costs: results from the United Kingdom Prospective Diabetes Study (UKPDS Study No. 65).
OBJECTIVE
To develop a model for estimating the immediate and long-term healthcare costs associated with seven diabetes-related complications in patients with Type 2 diabetes participating in the UK Prospective Diabetes Study (UKPDS).


METHODS
The costs associated with some major complications were estimated using data on 5102 UKPDS patients (mean age 52.4 years at diagnosis). In-patient and out-patient costs were estimated using multiple regression analysis based on costs calculated from the length of admission multiplied by the average specialty cost and a survey of 3488 UKPDS patients' healthcare usage conducted in 1996-1997.


RESULTS
Using the model, the estimate of the cost of first complications were as follows: amputation pound 8459 (95% confidence interval pound 5295, pound 13 200); non-fatal myocardial infarction pound 4070 ( pound 3580, pound 4722); fatal myocardial infarction pound 1152 ( pound 941, pound 1396); fatal stroke pound 3383 ( pound 1935, pound 5431); non-fatal stroke pound 2367 ( pound 1599, pound 3274); ischaemic heart disease pound 1959 ( pound 1467, pound 2541); heart failure pound 2221 ( pound 1690, pound 2896); cataract extraction pound 1553 ( pound 1320, pound 1855); and blindness in one eye pound 872 ( pound 526, pound 1299). The annual average in-patient cost of events in subsequent years ranged from pound 631 ( pound 403, pound 896) for heart failure to pound 105 ( pound 80, pound 142) for cataract extraction. Non-in-patient costs for macrovascular complications were pound 315 ( pound 247, pound 394) and for microvascular complications were pound 273 ( pound 215, pound 343) in the year of the event. In each subsequent year the costs were, respectively, pound 258 ( pound 228, pound 297) and pound 204 ( pound 181, pound 255).


CONCLUSIONS
These results provide estimates of the immediate and long-term healthcare costs associated with seven diabetes-related complications.
Clarke
P
P
Health Economics Research Centre and Diabetes Trials Unit, University of Oxford, Oxford, UK. philip.clarke@dphpc.ox.ac.uk
Gray
A
A
Legood
R
R
Briggs
A
A
Holman
R
R
D000553:Ambulatory Care / Q000191:economics; D000671:Amputation, Surgical / Q000191:economics; D001766:Blindness / Q000150:complications / Q000191:economics; D002387:Cataract Extraction / Q000191:economics; D003327:Coronary Disease / Q000150:complications / Q000191:economics; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000191:economics*; D003925:Diabetic Angiopathies / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009203:Myocardial Infarction / Q000150:complications / Q000191:economics; D011446:Prospective Studies; D020521:Stroke / Q000150:complications / Q000191:economics; D006113:United Kingdom