Quantifying the Financial Burden of HbA1c Levels: A Retrospective Single-Center Analysis of Healthcare Costs in South Korean Diabetes Patients.
Author(s)
Hansang Baek1, Dongjun Lim, MD PhD2, SungJu Kim, PhD3, Chulmin Kim, MD PhD2;
1Seoul, Korea, Republic of, 2Catholic University of Korea, Seoul, Korea, Republic of, 3Healthcare Group, Lee & Ko, Seoul, Korea, Republic of
1Seoul, Korea, Republic of, 2Catholic University of Korea, Seoul, Korea, Republic of, 3Healthcare Group, Lee & Ko, Seoul, Korea, Republic of
Presentation Documents
OBJECTIVES: The impact of glycemic control on healthcare costs is a critical area of research. This study aimed to evaluate the relationship between hemoglobin A1c (HbA1c) levels and healthcare costs, including out-of-pocket (OOP) expenses and insurance expenditures (IE), over a five-year period (2019-2023).
METHODS: This retrospective cohort study included data from Uijeongbu St. Mary's Hospital for patients who underwent HbA1c testing between January 1, 2019, and December 31, 2023. Patients were categorized into three groups based on their HbA1c levels: normoglycemic (NG, A1c < 6.5%), moderately (MG, 6.5 ≤ A1c < 8%), and highly hyperglycemic (HG, A1c ≥ 8%). The univariate linear regression model was used to evaluate the association between HbA1c levels and healthcare costs
RESULTS: A total of 86,417 patients were included, with 61,961 in the NG group, 15,065 in the MG group, and 9,391 in the HG group. The HG group incurred the highest total costs at the 75th percentile, reaching $8,554, compared to $7,169 in NG and $8,068 in MG. Each 1% increase in A1c was associated with a $236.11 rise in total healthcare costs. OOP costs and IE also grew by $55.58 and $180.53 per A1c unit, respectively. Additionally, patients with diabetes mellitus, chronic kidney disease, or serious disease exemption status, particularly those with suboptimal glycemic control, faced substantially higher costs. Particularly, patients under medical aid showed higher expenses in IE and OOP.
CONCLUSIONS: Elevated HbA1c is linked to increased healthcare costs. Effective management of glycemic levels is crucial to reduce financial burdens.
METHODS: This retrospective cohort study included data from Uijeongbu St. Mary's Hospital for patients who underwent HbA1c testing between January 1, 2019, and December 31, 2023. Patients were categorized into three groups based on their HbA1c levels: normoglycemic (NG, A1c < 6.5%), moderately (MG, 6.5 ≤ A1c < 8%), and highly hyperglycemic (HG, A1c ≥ 8%). The univariate linear regression model was used to evaluate the association between HbA1c levels and healthcare costs
RESULTS: A total of 86,417 patients were included, with 61,961 in the NG group, 15,065 in the MG group, and 9,391 in the HG group. The HG group incurred the highest total costs at the 75th percentile, reaching $8,554, compared to $7,169 in NG and $8,068 in MG. Each 1% increase in A1c was associated with a $236.11 rise in total healthcare costs. OOP costs and IE also grew by $55.58 and $180.53 per A1c unit, respectively. Additionally, patients with diabetes mellitus, chronic kidney disease, or serious disease exemption status, particularly those with suboptimal glycemic control, faced substantially higher costs. Particularly, patients under medical aid showed higher expenses in IE and OOP.
CONCLUSIONS: Elevated HbA1c is linked to increased healthcare costs. Effective management of glycemic levels is crucial to reduce financial burdens.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE249
Topic
Economic Evaluation
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)