Estimating the cost of complications of diabetes in Australia using administrative health-care data.
OBJECTIVE
To estimate Australian health-care costs in the year of first occurrence and subsequent years for major diabetes-related complications using administrative health-care data.


METHODS
The costs were estimated using administrative information on hospital services and primary health-care services financed through Australia's national health insurance system Medicare. Data were available for 70,340 patients with diabetes in Western Australia (mean duration of 4.5 years of follow-up). Multiple regression analysis was used to estimate inpatient and primary care costs.


RESULTS
For a man aged 60 years, the average costs in the year the event first occurred were: amputation $20,416 (95% CI 18,670-22,411); nonfatal myocardial infarction (MI) $11,660 (10,931-12,450); nonfatal stroke $14,012 (12,849-15,183); ischaemic heart disease $12,577 (12,026-13,123); heart failure $15,530 (13,965-17,009); renal failure $28,661 (22,989-34,202); and chronic leg ulcer $15,413 (13,089-18,123). The costs in subsequent years for a man aged 60 years range from 14% for nonfatal MI to 106% for renal failure, of event costs.


CONCLUSIONS
Estimates of the health-care costs associated with diabetes-related complications can be used in modeling the long-term costs of diabetes and in evaluating the cost-effectiveness of improving care.
Clarke
Philip
P
School of Public Health, University of Sydney, Sydney, NSW, Australia. philipc@health.usyd.edu.au
Leal
Jose
J
Kelman
Chris
C
Smith
Merran
M
Colagiuri
Stephen
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D048909:Diabetes Complications / Q000191:economics*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009313:National Health Programs / Q000191:economics*; D012044:Regression Analysis; D014904:Western Australia