title: Favorable cardiovascular risk factor profile is associated with lower healthcare expenditure and resource utilization among adults with diabetes mellitus free of established cardiovascular disease: 2012 Medical Expenditure Panel Survey (MEPS).
abstract: Given the prevalence and economic burden of diabetes mellitus (DM), we studied the impact of a favorable cardiovascular risk factor (CRF) profile on healthcare expenditures and resource utilization among individuals without cardiovascular disease (CVD), by DM status.
  
  
  
  25,317 participants were categorized into 3 mutually-exclusive strata: "Poor", "Average" and "Optimal" CRF profiles (≥4, 2-3, 0-1 CRF, respectively). Two-part econometric models were utilized to study cost data.
  
  
  
  Mean age was 45 (48% male), with 54% having optimal, 39% average, and 7% poor CRF profiles. Individuals with DM were more likely to have poor CRF profile vs. those without DM (OR 7.7, 95% CI 6.4, 9.2). Individuals with DM/poor CRF profile had a mean annual expenditure of $9,006, compared to $6,461 among those with DM/optimal CRF profile (p < 0.001).
  
  
  
  A favorable CRF profile is associated with significantly lower healthcare expenditures and utilization in CVD-free individuals across DM status, suggesting that these individuals require aggressive individualized prescriptions targeting lifestyle modifications and therapeutic treatments.
authors.affiliation: University of Miami Miller School of Medicine, Miami, FL, USA; The Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA.
authors.forename: David I
authors.initials: DI
authors.lastname: Feldman
authors.affiliation: Tecnologico de Monterrey, Catedra de Cardiologia y Medicina Vascular, Nuevo Leon, Mexico; Center for Healthcare Advancement and Outcomes Research, BHSF, Miami, FL, USA.
authors.forename: Javier
authors.initials: J
authors.lastname: Valero-Elizondo
authors.affiliation: Center for Healthcare Advancement and Outcomes Research, BHSF, Miami, FL, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Salami
authors.affiliation: Division of Cardiology and Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors.forename: Jamal S
authors.initials: JS
authors.lastname: Rana
authors.affiliation: Center for Healthcare Advancement and Outcomes Research, BHSF, Miami, FL, USA.
authors.forename: Oluseye
authors.initials: O
authors.lastname: Ogunmoroti
authors.affiliation: Center for Healthcare Advancement and Outcomes Research, BHSF, Miami, FL, USA.
authors.forename: Chukwuemeka U
authors.initials: CU
authors.lastname: Osondu
authors.affiliation: Center for Outcomes Research and Evaluation, Yale New Haven Hospital, Yale University, New Haven, CT, USA.
authors.forename: Erica S
authors.initials: ES
authors.lastname: Spatz
authors.affiliation: Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
authors.forename: Salim S
authors.initials: SS
authors.lastname: Virani
authors.affiliation: Non-Invasive Cardiovascular Imaging Program, Department of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Ron
authors.initials: R
authors.lastname: Blankstein
authors.affiliation: The Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.affiliation: Center for Healthcare Advancement and Outcomes Research, BHSF, Miami, FL, USA.
authors.forename: Emir
authors.initials: E
authors.lastname: Veledar
authors.affiliation: Center for Healthcare Advancement and Outcomes Research, BHSF, Miami, FL, USA; The Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA. Electronic address: KhurramN@baptisthealth.net.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D017046:Cost Savings; D048909:Diabetes Complications / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D017048:Health Care Costs; D019538:Health Care Surveys; D005102:Health Expenditures; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D016017:Odds Ratio; D017064:Process Assessment, Health Care / Q000191:economics*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Cardiovascular disease; Cardiovascular risk factor profile; Diabetes mellitus; Healthcare expenditures; Resource utilization