Presentation (CTI)

OBJECTIVES: Metabolic syndrome (MetS), characterized by obesity, hypertension, dyslipidaemia, and hyperglycaemia, is a major contributor to cardiovascular disease, type 2 diabetes, and increasing healthcare costs. Evidence on its economic burden in Slovakia is limited. This study estimated the nationwide direct healthcare cost burden associated with documented MetS in Slovakia.
METHODS: A retrospective population-based cohort study was conducted using a nationally representative 2% sample of the Slovak population with administrative healthcare records from the Slovak National Health Information Centre (NCZI) covering 2014-2023. MetS was defined as the presence of at least three documented components identified from diagnosis codes, prescription records, and procedure data. Annual costs of inpatient and outpatient care, medications, medical devices, dietetics, and transport were compared between individuals with and without MetS. Generalized estimating equations with a gamma distribution and log link were used to estimate adjusted healthcare costs accounting for repeated observations, age, sex, and calendar year. National costs were estimated by extrapolating the representative sample.
RESULTS: MetS was associated with substantially higher healthcare expenditure. Extrapolation to the Slovak population estimated €34.5 million in excess direct healthcare expenditure in 2023, increasing from €16.2 million in 2014. Healthcare costs increased with the number of MetS components, reaching an adjusted excess annual cost of €664 among individuals with all five components compared with those without MetS. Hyperglycaemia was associated with the largest excess annual cost (€724), followed by hypertension (€248), hypertriglyceridaemia (€225), dyslipidaemia (€210), and obesity (€45). Adjusted annual healthcare costs were €1,129 for individuals with MetS and €949 for those without MetS, corresponding to an excess of €180 per patient-year.
CONCLUSIONS: Documented MetS is associated with a substantial direct healthcare cost burden in Slovakia. Earlier identification and management of metabolic risk factors, particularly hyperglycaemia, may reduce healthcare expenditure and improve the long-term sustainability of the healthcare system.