title: Resource utilization and healthcare costs for acute coronary syndrome patients with and without diabetes mellitus.
abstract: OBJECTIVE
  This study compared differences in healthcare costs and resource utilization for acute coronary syndrome (ACS) patients with and without diabetes mellitus (DM).
  
  
  METHODS
  A retrospective cohort study of a large, US employer-based claims database identified adults hospitalized for ACS between 01/01/2005 and 12/31/2006 and categorized them based on DM status. Resource utilization and costs during the index hospitalization and in the 12-month follow-up period were compared for ACS patients with and without DM using the propensity score stratification bootstrapping method, adjusting for differences in demographic and clinical characteristics.
  
  
  RESULTS
  Of 12,502 patients who met selection criteria, 3,040 (24%) had a history of DM and 9,462 (76%) did not. Patients with DM were older, female, and had higher rates of previous cardiovascular and renal diseases. After the propensity score stratification, patients with DM incurred higher index hospitalization costs ($32,577 vs. $29,150, p < 0.01) as well as higher total follow-up healthcare costs ($35,400 vs. $24,080, p < 0.01), including higher inpatient ($17,278 vs. $11,247, p < 0.01), outpatient ($12,357 vs. $8,853, p < 0.01), and pharmacy costs ($5,765 vs. $3,980, p < 0.01).
  
  
  CONCLUSIONS
  General limitations exist with any retrospective claims database analysis including potential diagnostic or procedural coding inaccuracies. Additionally, the patient population was representative of a working-age population with employer-sponsored health insurance and results may not be generalizable to other patient populations.
  
  
  CONCLUSIONS
  DM is significantly associated with increased healthcare resource utilization and costs for ACS patients.
authors.affiliation: Eli Lilly and Company, Indianapolis, IN 46285, USA. zhaozhenxiang@lilly.com
authors.forename: Zhenxiang
authors.initials: Z
authors.lastname: Zhao
authors.forename: Baojin
authors.initials: B
authors.lastname: Zhu
authors.forename: Johnna
authors.initials: J
authors.lastname: Anderson
authors.forename: Haoda
authors.initials: H
authors.lastname: Fu
authors.forename: Leroy
authors.initials: L
authors.lastname: LeNarz
mesh_terms: D054058:Acute Coronary Syndrome / Q000191:economics* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D048909:Diabetes Complications / Q000191:economics*; D005260:Female; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult