IMPACT OF BASELINE COMORBIDITIES AND COMBINATIONS OF COMORBIDITIES AMONG PEOPLE WITH TYPE 2 DIABETES ON HEALTH CARE RESOURCE UTILISATION IN THE UK
Author(s)
Tariq Halasa, MSc, PhD1, Jens Gundgaard, MSc, PhD1, Alik Vodyanov, MSc2, Joe Hollinghurst, MSc2.
1Novo Nordisk A/S, Bagsvaerd, Denmark, 2HEOR Ltd, Cardiff, United Kingdom.
1Novo Nordisk A/S, Bagsvaerd, Denmark, 2HEOR Ltd, Cardiff, United Kingdom.
OBJECTIVES: To investigate the impact of combinations of comorbidities in people with type-2 diabetes (PwT2D) on healthcare resource utilisation (HCRU)
METHODS: An observational study was conducted using the UK Clinical Practice Research Datalink. Adults with a T2D diagnosis, active T2D treatment, and at least one HbA1c record were included and followed until death or up to 5-years. Generalised linear models stratified by single and combinations of 20 comorbidities and adjusted for age, diabetes duration, and time in study were estimated. HCRU outcomes included GP visits, probability of hospital admissions, length of stay, outpatient visits, and emergency room visits at 1-, 3- and 5-years
RESULTS: The study included 162,519 females and 241,883 males with an average age of 66.6 (13.7) and 63.4 (12.7) years, respectively. Common comorbidities were hypertension (males 62.2%, females 66.1%), dyslipidaemia (males 28.6%, females 28.1%) and osteoarthritis (males 18.5%, females 29.9%). Adjusted 5-year estimates were computed for a 65-year-old with 8-years of T2D. Singularly, diabetic ulcer contributed to the highest burden for HCRU outcomes (GP, 19-visits [18.8, 19.3]; hospital admission 83% [82%, 85%]; length-of-stay 40-days [39.4, 40.1]; outpatient 31.3-visits [31.0, 31.6]; ER 3.9-visits [3.8, 4.0]), except for ER visits, where suicidal ideation had the highest burden (4.2-visits [4.1, 4.3]). Multiple comorbidities increased burden, having diabetic ulcer and coronary artery disease indicated high HCRU (GP, 23-visits [22.7, 23.7]; hospital admission 91% [88%, 93%]; length-of-stay 55-days [53.9, 55.4]; outpatient 35.5-visits [34.8, 36.1]; ER 5.8-visits [5.6, 6.1]). Having no comorbidities of interest resulted in the lowest HCRU (GP, 6.84-visits [6.8, 6.9]; hospital admission 53% [52%, 54%]; length-of-stay 7.34-days [7.29, 7.38]; outpatient 9.06-visits [9.01, 9.12]; ER 1.35-visits [1.33, 1.37]).
CONCLUSIONS: Comorbidities substantially increase HCRU among people with T2D, with combinations of comorbidities exacerbating this effect. These findings may highlight the importance of early identification and proactive management of high‑risk comorbidity profiles to improve HCRU
METHODS: An observational study was conducted using the UK Clinical Practice Research Datalink. Adults with a T2D diagnosis, active T2D treatment, and at least one HbA1c record were included and followed until death or up to 5-years. Generalised linear models stratified by single and combinations of 20 comorbidities and adjusted for age, diabetes duration, and time in study were estimated. HCRU outcomes included GP visits, probability of hospital admissions, length of stay, outpatient visits, and emergency room visits at 1-, 3- and 5-years
RESULTS: The study included 162,519 females and 241,883 males with an average age of 66.6 (13.7) and 63.4 (12.7) years, respectively. Common comorbidities were hypertension (males 62.2%, females 66.1%), dyslipidaemia (males 28.6%, females 28.1%) and osteoarthritis (males 18.5%, females 29.9%). Adjusted 5-year estimates were computed for a 65-year-old with 8-years of T2D. Singularly, diabetic ulcer contributed to the highest burden for HCRU outcomes (GP, 19-visits [18.8, 19.3]; hospital admission 83% [82%, 85%]; length-of-stay 40-days [39.4, 40.1]; outpatient 31.3-visits [31.0, 31.6]; ER 3.9-visits [3.8, 4.0]), except for ER visits, where suicidal ideation had the highest burden (4.2-visits [4.1, 4.3]). Multiple comorbidities increased burden, having diabetic ulcer and coronary artery disease indicated high HCRU (GP, 23-visits [22.7, 23.7]; hospital admission 91% [88%, 93%]; length-of-stay 55-days [53.9, 55.4]; outpatient 35.5-visits [34.8, 36.1]; ER 5.8-visits [5.6, 6.1]). Having no comorbidities of interest resulted in the lowest HCRU (GP, 6.84-visits [6.8, 6.9]; hospital admission 53% [52%, 54%]; length-of-stay 7.34-days [7.29, 7.38]; outpatient 9.06-visits [9.01, 9.12]; ER 1.35-visits [1.33, 1.37]).
CONCLUSIONS: Comorbidities substantially increase HCRU among people with T2D, with combinations of comorbidities exacerbating this effect. These findings may highlight the importance of early identification and proactive management of high‑risk comorbidity profiles to improve HCRU
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH167
Topic
Economic Evaluation, Epidemiology & Public Health, Patient-Centered Research
Topic Subcategory
Public Health
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)