title: Direct costs of care in germany for children and adolescents with diabetes mellitus in the early course after onset.
abstract: OBJECTIVE
  Prospective population-based cost-of-illness study to evaluate diabetes mellitus (DM)-related direct costs in German pediatric DM care in the early course after onset (perspective: statutory health insurers).
  
  
  METHODS
  573 patients with DM <15 years of age were followed for up to 2 years after onset. DM-related hospitalization and ambulatory care, insulin and self-testing regimen were ascertained. Costs per patient-year were estimated (2000 prices). Using multivariate regression, associations between costs and families' socioeconomic status was evaluated.
  
  
  RESULTS
  Mean total costs per patient-year were 7,069 euro (interquartile range 5,414-8,127). Onset hospitalization accounted for the majority of costs (4,908 euro, 3,728-6,213). Within post-onset costs, most were attributable to blood glucose self measurement and hospitalization (36% and 32%). Costs were significantly higher in children from families with lower compared to highest educated parents and in children from non-German families (p <0.01).
  
  
  CONCLUSIONS
  Among the direct medical costs of childhood DM in the early course after onset, the greatest economic burden was due to hospitalization, in particular at onset. Blood glucose self measurement accounted for the majority of the post-onset costs. Costs were associated with the socio-economic status. It is recommended to evaluate the cost-effectiveness of outpatient programs targeting children from families with lower social status.
authors.affiliation: Department of Biometrics and Epidemiology, German Diabetes Research Institute at Heinrich-Heine-University, Düsseldorf, Germany. icks@ddfi.uni-duesseldorf.de
authors.forename: Andrea
authors.initials: A
authors.lastname: Icks
authors.forename: Joachim
authors.initials: J
authors.lastname: Rosenbauer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rathmann
authors.forename: Burkhard
authors.initials: B
authors.lastname: Haastert
authors.forename: Afschin
authors.initials: A
authors.lastname: Gandjour
authors.forename: Guido
authors.initials: G
authors.lastname: Giani
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000191:economics* / Q000628:therapy*; D004180:Direct Service Costs; D004493:Education; D005260:Female; D005858:Germany; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D009313:National Health Programs / Q000191:economics; D040841:Resource Allocation; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose