HEALTH CARE UTILIZATION AND DIRECT ECONOMIC BURDEN OF DIABETES PATIENTS UNDER ONE URBAN HEALTH INSURANCE SCHEME OF CHINA
Author(s)
Chen W1, Lou J2, Zhu J2
1Center for Pharmacoeconomic Research and Evaluation, School of Public Health, Fudan University, Shanghai, China, 2Fudan University, Shanghai, China
OBJECTIVES: The objective of the study was to measure the health care utilization and direct economic burden of diabetic patients covered by urban employee basic medical insurance (UEBMI) in urban China. METHODS: All diabetic patients enrolled in UEBMI in a sample city from 2009 through 2011 were included. Retrieved data included patient personal information, complications and co-morbidities (CCs), service utilization, total medical expense and expense reimbursed by the scheme. Descriptive analysis was employed to examine the service utilization and direct economic burden. RESULTS: There were 1695, 1824, and 2088 diabetic patients treated in the schemes from 2009 through 2011, respectively. The proportion of women was around 38% each year. The patients aged 50-80 accounted for about 80%. The percentages of chronic CCs increased year by year. Neuropathy, hypertension, and cardiovascular and cerebrovascular diseases were the top three CCs, accounting for 53.83%, 51.63%, and 28.40% in 2011, respectively. 63%-65% patients were managed by only oral glucose-lowering treatments. Each patient had the average of 30 outpatient visits and 1.5 hospitalization stays each year. In three years, average medical expense per patient was RMB 15,387, 16,817 and 18,714, respectively. A little more than 30% of total expenses were paid out-of-pocket by patients. Medicines accounted for over 74% of total expenses, but medicines for glycemic control only occupied 23%. The top 8 products most used for glucose control accounted for 79% of total medicine costs, in which, acarbose and metformin were ranked as the first two products, amounting to 34% of total medicine costs. CONCLUSIONS: Chronic CCs in diabetic patients brought higher medical service utilization. Direct economic burden and service utilization increased year by year. Medicines was the main expense, but used for other purposes rather than glycemic control. The rational use of medicines and CCs monitoring and management should be promoted in China.
Conference/Value in Health Info
2014-05, ISPOR 2014, Palais des Congres de Montreal
Value in Health, Vol. 17, No. 3 (May 2014)
Code
PDB87
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders