title: Relationships between diabetes and medical and dental care costs: findings from a worksite cohort study in Japan.
abstract: The purpose of this study was to evaluate the relationships between diabetes and medical and dental care costs from a 5-yr prospective observation of Japanese workers. The data were derived from health and dental examinations and health insurance claims of 4,086 workers aged 40-54 yr. At baseline, the subjects were assigned to four categories: known diabetes; undiagnosed diabetes; impaired fasting glucose (IFG); and non-diabetic. The differences in health care costs among the non-diabetics, IFG and undiagnosed diabetes groups were not seen at baseline, but the costs incurred by the subjects with undiagnosed diabetes substantially increased thereafter. Over 5 yr of the study period, compared with the non-diabetic group, subjects with known diabetes incurred 3.9- and 2.9-fold higher annual inpatient and outpatient costs, respectively, while subjects in the undiagnosed diabetes group incurred 3.0- and 1.6-fold higher costs, respectively. There were no significant associations between annual dental care costs and diabetic status. The excess costs of medical care among subjects with diabetes were attributable to diabetes itself, heart disease and cerebrovascular disease, but not cancer. Among middle-aged workers, diabetics incurred significantly greater medical care costs than non-diabetics, whereas IFG was not associated with higher costs.
authors.affiliation: Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan. r-ochide@med.uoeh-u.ac.jp
authors.forename: Reiko
authors.initials: R
authors.lastname: Ide
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Hoshuyama
authors.forename: Donald John
authors.initials: DJ
authors.lastname: Wilson
authors.forename: Ken
authors.initials: K
authors.lastname: Takahashi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Higashi
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016001:Confidence Intervals; D003729:Dental Care / Q000191:economics*; D003920:Diabetes Mellitus / Q000191:economics* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D018149:Glucose Intolerance; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016272:Occupational Health / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011446:Prospective Studies; D013223:Statistics as Topic; D017132:Workplace