title: Major complications have an impact on total annual medical cost of diabetes: results of a database analysis.
abstract: BACKGROUND
  Type 2 diabetes mellitus is a common, chronic, and costly disease, and its prevalence is increasing in major industrialized countries. Diabetes has indeed a high social impact mainly because of its chronic complications.
  
  
  OBJECTIVE
  The aim of this study was to analyze the direct medical costs attributable to Type 2 diabetes mellitus and its determinants, as assessed in a diabetologic center (DC) in Italy.
  
  
  METHODS
  We conducted a retrospective longitudinal cost of care study; Type 2 diabetic patients who visited between January 2001 and August 2002 were randomly selected from the database of the DC of Portogruaro. Cost data collected included hospitalizations, visits, diagnostics, and pharmacological therapies and were quantified and analyzed in the perspective of the National Health Service (NHS).
  
  
  RESULTS
  Two hundred ninety-nine diabetic patients were extracted, with a mean/patient follow up of 476 days. Mean age was 67.5 years and males represented 67.2% of the sample. The average annual health care cost was found to be euro1909.67 per patient; pharmacological therapies accounted for the greatest proportion of direct medical costs (52%), followed by hospitalization (28%) and diagnostic exams (11%). Annual costs increased with the number of diabetes related comorbidities, from euro1039 to 3141 per patient in participants with none or more than two complications, respectively.
  
  
  CONCLUSIONS
  Long-term complications carry a considerable impact on total annual medical cost. Our study demonstrates that an increase in the number of comorbidities is directly associated with an increase of Type 2 diabetes cost. Strategies aimed at preventing the onset of diabetic complications are likely to reduce medical costs in the long run, while improving patients' health.
authors.affiliation: Centro di Farmacoeconomia, Università degli Studi di Milano, Milano, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Morsanutto
authors.forename: Patrizia
authors.initials: P
authors.lastname: Berto
authors.forename: Stefania
authors.initials: S
authors.lastname: Lopatriello
authors.forename: Renzo
authors.initials: R
authors.lastname: Gelisio
authors.forename: Dario
authors.initials: D
authors.lastname: Voinovich
authors.forename: Paola Perelli
authors.initials: PP
authors.lastname: Cippo
authors.forename: Lorenzo Giovanni
authors.initials: LG
authors.lastname: Mantovani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000847:Annual Reports as Topic; D019411:Clinical Laboratory Techniques / Q000191:economics / Q000706:statistics & numerical data; D003365:Costs and Cost Analysis / Q000379:methods / Q000706:statistics & numerical data; D016208:Databases, Factual; D048909:Diabetes Complications / Q000191:economics*; D004358:Drug Therapy / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006282:Health Personnel / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data