OBJECTIVES: Diabetes is a chronic disease that places a huge burden on the Tasmanian healthcare system. However, to-date, no data has been published on the economic burden of diabetes in Tasmania. This study aimed to quantify the excess direct medical costs in people with diabetes from the healthcare system perspective; and to identify trends in the excess costs from 2007-2017 in Tasmania, Australia.

METHODS: This was a matched retrospective cohort study based on linked data. Using propensity score matching, 51,324 people with diabetes were matched on age, sex, and residential area with 102,648 people without diabetes. Direct medical costs (Australian dollars 2020-2021) due to hospitalisation, Emergency Department visits and pathology tests were included. The absolute and relative difference between mean annual costs of people with diabetes and their controls were calculated and stratified by sex, age group, and socioeconomic status.

RESULTS: On average, people with diabetes had healthcare costs that were almost double their controls ($2,427 (95% confidence interval 2,322-2,543); ratio 1.87 (95% CI 1.85-1.91); p < 0.001). While in 2007, the costs of a person with diabetes were $1,643 (95% CI 1,489-1,806) more than their control, this increased to $2,480 (95% CI 2,265-2,680) in 2017. Although the absolute difference in costs was higher in older age groups (≥70: $2,498 (95% CI 2,265-2,754); 40-49: $2,117 (95% CI 1,887-2,384)), the relative difference was higher in younger age groups (≥70: ratio 1.52 (95% CI 1.48-1.56); 40-49: ratio 2.37 (95% CI 2.25-2.61)).

CONCLUSIONS: People with diabetes required substantially greater healthcare expenditure than people without diabetes of similar age, sex, and residential area. Given the increasing burden that diabetes imposes, our findings will support policymakers in future planning for diabetes and enable targeted interventions for those sub-groups with higher long-term costs.