title: Costs of paediatric diabetes care in Germany: current situation and comparison with the year 2000.
abstract: OBJECTIVE
  To estimate direct costs of paediatric Type 1 diabetes care and associated factors in Germany for the year 2007 and to compare results with the costs for the year 2000.
  
  
  METHODS
  Our study includes clinical data and charges for any diabetes-related health care service of 14,185 continually treated subjects with paediatric diabetes aged < 20 years [52.5% male, mean age (SD) 12.1 (4.2) years], derived from a nationwide prospective patient documentation system (DPV). Health-care utilization was valued in monetary terms by using inpatient and outpatient medical fees and retail prices (perspective of the statutory health insurance). Associations between average total diabetes-related costs or various single cost categories per patient and age, sex, migration background, diabetes duration, and metabolic control were analysed by multiple regression procedures and by a two-part model for hospitalization costs. Total direct costs in the whole paediatric diabetes population in Germany were estimated. Mean costs per patient as well as total costs in the German paediatric diabetes population in 2007 were compared to 2000 costs (inflated to the year 2007).
  
  
  RESULTS
  Mean direct diabetes-associated costs per subject were €3524 (inter-quartile range: 1831-4743). Main cost categories were hospitalization (32%), glucose self-monitoring (29%), insulin pump therapy (18%), and insulin (15%). Based on the present estimation, the total costs of paediatric diabetes care in Germany exceeded €110 million in 2007. Compared with estimates of the year 2000, average costs per patient had increased by 20% and total costs for German paediatric diabetes care by 47%.
  
  
  CONCLUSIONS
  Direct costs for paediatric Type 1 diabetes care increased between 2000 and 2007, probably partly because of new therapeutic strategies and an increase in diabetes prevalence.
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Centre, Leibniz Center at the Heinrich Heine University, Düsseldorf, Germany. christina.baechle@ddz.uni-duesseldorf.de
authors.forename: C C
authors.initials: CC
authors.lastname: Bächle
authors.forename: R W
authors.initials: RW
authors.lastname: Holl
authors.forename: K
authors.initials: K
authors.lastname: Straßburger
authors.forename: E
authors.initials: E
authors.lastname: Molz
authors.forename: N
authors.initials: N
authors.lastname: Chernyak
authors.forename: P
authors.initials: P
authors.lastname: Beyer
authors.forename: U
authors.initials: U
authors.lastname: Schimmel
authors.forename: H
authors.initials: H
authors.lastname: Rütschle
authors.forename: J
authors.initials: J
authors.lastname: Seidel
authors.forename: R
authors.initials: R
authors.lastname: Lepler
authors.forename: M
authors.initials: M
authors.lastname: Holder
authors.forename: J
authors.initials: J
authors.lastname: Rosenbauer
authors.forename: A
authors.initials: A
authors.lastname: Icks
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000191:economics*; D015190:Blood Glucose Self-Monitoring / Q000191:economics; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000191:economics*; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000008:administration & dosage / Q000191:economics*; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin