Prevalence and Economic Burden for Diabetic Multimorbid Patients in China: Based on Longitudinal Claims Data

OBJECTIVES: Over 90% of diabetic patients experience one or more co-morbidities, significantly impacting their quality of life and imposing a substantial economic burden. This study aims to understand the prevalence and economic burden among diabetic multimorbid patients in China.

METHODS: This study used cohort data from a chronic disease management database and health insurance claim database from 2014 to 2019 from a city in eastern China. Thirty comorbidities and complications with a prevalence rate higher than 1% were ascertained through a literature review and real-world data analysis. The prevalence and economic burden of the above-related diseases were determined using ICD-10 and descriptive analysis.

RESULTS: This study included 79,910 diabetic patients, in which the number of diabetic multimorbidity patients increased from 69,563 (87.0%) in 2014 to 72,277 (90.5%) in 2019. Thirteen out of the thirty identified comorbidities and complications boasted a prevalence rate exceeding 5.0%. In 2019, hypertension (71.9%) had the highest prevalence among diabetes patients, followed by arthritis (35.9%), chronic ischemic heart disease (27.9%), hyperlipidemia (20.1%) and chronic gastritis (18.8%). The average annual treatment cost for diabetes patients grew from $2,852.5 in 2014 to $4,845.5 in 2019. Meanwhile, the average annual treatment cost for multimorbidity as a percentage of the average annual treatment cost increased from 23.1% in 2014 to 29.3% in 2019. Among them, in 2019, the highest average annual cost of treatment was cerebrovascular disease sequelae ($3,851.5), followed by cerebral infarction ($2,762.2), renal failure ($1,540.2), heart failure ($2,009.7), and chronic obstructive pneumonia ($1,371.5).

CONCLUSIONS: Multimorbidity status is prevalent in Chinese diabetic patients, resulting in an escalating economic burden. Primary prevention strategies for diabetic patients should be intensified to prevent and manage the onset and progression of comorbidities and complications, thus maintaining patient health and curbing healthcare expenses.