title: Direct costs in diabetic and non diabetic people: the population-based Turin study, Italy.
abstract: OBJECTIVE
  We compared direct costs of diabetic and non diabetic people covered by the Italian National Health System, focusing on the influence of age, sex, type of diabetes and treatment.
  
  
  RESULTS
  Diabetic people living in Turin were identified through the Regional Diabetes Registry and the files of hospital discharges and prescriptions. Data sources were linked to the administrative databases to assess health care services used by diabetic (n = 33,792) and non diabetic people(n = 863,123). Data were analyzed with the two-part model; the estimated direct costs per person/year were €3660.8 in diabetic people and €895.6 in non diabetic people, giving a cost ratio of 4.1. Diabetes accounted for 11.4% of total health care expenditure. The costs were attributed to hospitalizations (57.2%), drugs (25.6%), to outpatient care (11.9%), consumable goods (4.4%) and emergency care (0.9%). Estimated costs increased from € 2670.8 in diabetic people aged <45 years to € 3724.1 in those aged >74 years, the latter representing two third of the diabetic cohort; corresponding figures in non diabetic people were € 371.6 and € 2155.9. In all expenditure categories cost ratios of diabetic vs non diabetic people were higher in people aged <45 years, in type 1 diabetes and in insulin-treated type 2 diabetes.
  
  
  CONCLUSIONS
  Direct costs are 4-fold higher in diabetic than in non diabetic people, mainly due to care of the elderly and inpatient care. In developed countries, demographic changes will have a profound impact on costs for diabetes in next years.
authors: Department of Internal Medicine, University of Turin, Corso Dogliotti 14, I-10126 Turin, Italy. graziella.bruno@unito.it
authors: G
authors: G
authors: Bruno
authors: R
authors: R
authors: Picariello
authors: A
authors: A
authors: Petrelli
authors: F
authors: F
authors: Panero
authors: G
authors: G
authors: Costa
authors: P
authors: P
authors: Cavallo-Perin
authors: M
authors: M
authors: Demaria
authors: R
authors: R
authors: Gnavi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D016527:Drug Costs; D011307:Drug Prescriptions; D004632:Emergency Medical Services / Q000191:economics; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics* / Q000627:therapeutic use*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D018803:Models, Economic; D010351:Patient Discharge; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents