Cost of Type 2 Diabetes mellitus in Hong Kong Chinese.
OBJECTIVE
Hong Kong (HK) is a special administrative region of China as well as being a metropolitan city. In HK, like in many developed countries, Diabetes mellitus, with over 97% of diabetic patients having Type 2 Diabetes mellitus (Type 2 DM), is a growing public health problem but the local financial burden has never been investigated. The primary objectives of this study were to evaluate from the social perspective the costs of Type 2 DM, to identify the major cost drivers, and the proportion of the burden shared by the government, patient and the society. The study was carried out in a group of Hong Kong Chinese patients attending a government hospital. The economic impact of Type 2 DM on local and governmental healthcare expenditure was also examined.


METHODS
A retrospective cohort observational study was conducted in Type 2 DM patients attending the Diabetes Mellitus Outpatient Clinic at a public hospital in the period January 2004 to May 2004, in which 204 patients were randomly selected and invited to join this study. A total of 147 patients were subsequently enrolled giving an inclusion rate of 72%.


RESULTS
Annual total cost of Type 2 DM in a patient was US$ 1,725 +/- 2,044 (HK$ 13,457 +/- 15,943) with direct costs accounting for > 87.9%. The government was the major payer with over 78.4% of the total costs. Annual total direct medical costs per patient were US$ 1,492 +/- 1,716 (HK$ 11,638 +/- 13,386) of which the government paid 90.6%. Direct medical costs increased markedly if complications were present. In patients with microvascular or macrovascular complications only, the costs increased 1.1-fold compared to those for patients without complications. If both microvascular and macrovascular complications were present in the same patient, the costs were 1.3-fold higher than in patients without complications.


CONCLUSIONS
Costs of Type 2 DM have a significant impact on the local healthcare budget. It contributed in 2004 up to 3.9% of the total HK healthcare expenditure and 6.4% of the HK Hospital Authority's (public sector) expenditures on health.
Chan
B S W
BS
School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. bonnyswchan@yahoo.com.hk
Tsang
M W
MW
Lee
V W Y
VW
Lee
K K C
KK
D000368:Aged; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000453:epidemiology; D004180:Direct Service Costs; D004526:Efficiency; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006723:Hong Kong / Q000453:epidemiology; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018401:Sample Size; D012959:Socioeconomic Factors