Presentation (CTI)

OBJECTIVES: As diabetes prevalence increases, managing cardiorenal comorbidity burden has become a growing challenge. This burden has resulted in increasing barriers to healthcare access and affordability. This study aims to understand how healthcare access, utilization, and expenditures impact U.S. adults with diabetes and cardiorenal comorbidities.
METHODS: Data from the 2018-2022 Medical Expenditure Panel Survey (MEPS) for adults ≥ 18 was used. Conditions were identified using ICD-10 codes and self-reported. Individuals were categorized as having no diabetes, diabetes without cardiorenal comorbidities, or diabetes with cardiorenal comorbidities (heart failure (HF), atherosclerotic cardiovascular disease (ASCVD), and renal disease). Analyses compared healthcare access (affordability problems and treatment delays due to cost), healthcare utilization, and expenditures across groups.
RESULTS: Of 107,722 adults, 14,895 had diabetes. Among those with diabetes, 9,896 (66.4%) had no evidence of cardiorenal comorbidity, 1,135 (7.6%) had renal disease, 4,333 (29.1%) ASCVD, and 384 (2.6%) HF. Access-related problems affected 14.5% of adults with diabetes versus 10.8% of those without diabetes; more individuals with diabetes + cardiorenal comorbidity reported access problems (15-18%) than those without (13%). Those with diabetes and renal disease, ASCVD, or HF had higher healthcare utilization than those without cardiorenal comorbidities, including emergency room visits (0.84, 0.67, and 1.03 vs 0.28), outpatient visits (12.26, 8.02, and 9.82 vs 4.98), prescription medicine use (50.22, 43.36, and 63.66 vs 27.65), hospitalizations (0.54, 0.45, and 0.78 vs 0.13), and length of stays (3.65, 2.85, and 5.21 vs 0.71). In addition, total healthcare payments ($20,528, $12,939, and $25,905 vs $5,344), total prescription payments ($5,322, $3,220, and $5,969 vs $1,146), out-of-pocket total costs ($698, $539, and $691 vs $404.50), and out-of-pocket prescription costs ($221, $172, and $297.50 vs $108).
CONCLUSIONS: Overall, adults living with diabetes and cardiorenal events faced greater healthcare use and higher costs, along with more access challenges, than those without diabetes or without cardiorenal events.