Direct medical cost of type 2 diabetes in singapore

• Published in: PloS one Vol. 10; no. 3; p. e0122795
• Main Authors: Shuyu Ng, Charmaine, Toh, Matthias Paul Han Sim, Ko, Yu, Yu-Chia Lee, Joyce
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 27-03-2015; Public Library of Science (PLoS)
• Subjects: Aged; Ambulatory care; Analysis; Cardiovascular diseases; Chronic diseases; Chronic illnesses; Complications; Cost analysis; Cost of Illness; Data base management systems; Demographic variables; Demographics; Diabetes; Diabetes Complications - economics; Diabetes Complications - epidemiology; Diabetes Complications - pathology; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - economics; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - pathology; Disease control; Economic aspects; Emergency medical services; Female; Health aspects; Health care costs; Health care expenditures; Hospital costs; Hospitalization; Humans; Hypertension; Inpatients; Insulin; Insulin - economics; Insulin - therapeutic use; Laboratories; Laboratory tests; Male; Middle Aged; Nephropathy; Oral drugs; Outpatients; Patients; Pharmacy; Physicians; Preventive medicine; Primary care; Public health; Singapore; Stroke; Type 2 diabetes; Vascular diseases; Singapore; United States > US; Taiwan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0122795

Due to the chronic nature of diabetes along with their complications, they have been recognised as a major health issue, which results in significant economic burden. This study aims to estimate the direct medical cost associated with type 2 diabetes mellitus (T2DM) in Singapore in 2010 and to examine both the relationship between demographic and clinical state variables with the total estimated expenditure. The National Healthcare Group (NHG) Chronic Disease Management System (CDMS) database was used to identify patients with T2DM in the year 2010. DM-attributable costs estimated included hospitalisations, accident and emergency (A&E) room visits, outpatient physician visits, medications, laboratory tests and allied health services. All charges and unit costs were provided by the NHG. A total of 500 patients with DM were identified for the analyses. The mean annual direct medical cost was found to be $2,034, of which 61% was accounted for by inpatient services, 35% by outpatient services, and 4% by A&E services. Independent determinants of total costs were DM treatments such as the use of insulin only (p<0.001) and the combination of both oral medications and insulin (p=0.047) as well as having complications such as cerebrovascular disease (p<0.001), cardiovascular disease (p=0.002), peripheral vascular disease (p=0.001), and nephropathy (p=0.041). In this study, the cost of DM treatments and DM-related complications were found to be strong determinants of costs. This finding suggests an imperative need to address the economic burden associated with diabetes with urgency and to reorganise resources required to improve healthcare costs.