The impact of acute myocardial infarction and stroke on health care costs in patients with type 2 diabetes in Sweden.
BACKGROUND
Estimates of the economic impact of cardiovascular events in patients with type 2 diabetes are scarce. The aim of this study was to determine the health care costs associated with acute myocardial infarction (AMI) and stroke in patients with type 2 diabetes in Sweden.


METHODS
Population-based open cohort study of 9941 patients with type 2 diabetes retrospectively identified in primary care records at 26 centres in Uppsala County.


METHODS
Episodes of AMI and stroke suffered by study patients were tracked in the Swedish National Inpatient Register. Annual per patient costs of health care were computed for the years 2000-2004 using register data covering inpatient care, outpatient hospital care, primary care and drugs. Panel data regression was applied to determine the impact of suffering a first or repeat AMI or stroke on health care costs during the year of the event and in subsequent years.


RESULTS
Total health care costs of patients suffering a first AMI/stroke increased by 4.1/6.5 during the year of the event [95% confidence interval (CI): 3.1-5.4/4.9-8.5] and by 1.1/1.4 during subsequent years (95% CI: 1.0-1.3/1.2-1.6), controlling for age, sex, the event of amputation and presence of renal failure, heart failure and diabetic eye disease. Total health care costs of patients suffering a first or repeat AMI/stroke increased by 4.1/6.4 during the year of an event (95% CI: 3.2-5.2/5.0-8.1) but were not significantly higher during subsequent years.


CONCLUSIONS
Estimates of the costs related to major cardiovascular complications of type 2 diabetes are critical input to economic evaluations.
Ringborg
Anna
A
i3 Innovus, Karolinska Institute, Stockholm, Sweden. anna.ringborg@ki.se
Yin
Donald D
DD
Martinell
Mats
M
Stålhammar
Jan
J
Lindgren
Peter
P
D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D005260:Female; D017048:Health Care Costs; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009203:Myocardial Infarction / Q000191:economics* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000191:economics* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome