COST OF MALNUTRITION IN ELDERLY MEDICARE ENROLLEES WITH DIABETES
Author(s)
Goates S, Ahmed N, Chakraborty S, Mustad V
Abbott Nutrition, Columbus, OH, USA
Presentation Documents
OBJECTIVES: Diabetes is prevalent condition in elderly Medicare enrollees, and has been linked to costly comorbidities. The cost of malnutrition in this population, however, has not been quantified. Our objective is to estimate the cost of malnutrition in elderly Medicare enrollees diagnosed with diabetes. METHODS: We used claims data from 2000 to 2013 for a random sample of 15,000 Medicare enrollees (age>= 65) diagnosed with diabetes while enrolled in Medicare (96,370 subject years). Malnutrition was identified by ICD9 codes in the claims data. Cost data were reported for each subject year, and were categorized by service type (Part A, Part B and Part C) and payer (Medicare, Primary Insurance or Beneficiary). The impact of malnutrition on healthcare costs was estimated using two way random effects panel regressions. Results are reported with and without controlling for comorbidities. RESULTS: Nearly 16 percent of enrollees received a malnutrition diagnosis during our study period (15.9%). Enrollees who had been diagnosed with malnutrition had medical costs that were $33,648 higher than other enrollees controlling for age and gender (p<0.01). When cardiopulmonary disease, kidney disease, cancer and depression were included in the regression, malnutrition raised total costs $23,698 per year (p<0.01). For comparison, a diagnosis of lung cancer (the next most costly condition) raised total cost $16,820 (p<0.01). The majority of malnutrition associated increased cost was borne by Medicare, which paid $21,605 more per malnourished patients after controlling for age, gender and comorbidities (p<0.01). Medicare Part A had the highest increase in malnutrition associated cost ($18,007; p<0.01) followed by Part B ($3017, p<0.01) and Part D ($281, p<0.01). CONCLUSIONS: Diabetes is a common and costly disease, which is made more costly by malnutrition. Health care providers should carefully monitor the nutritional status of patients with diabetes and integrate nutrition into patient care plans.
Conference/Value in Health Info
2017-05, ISPOR 2017, Boston, MA, USA
Value in Health, Vol. 20, No. 5 (May 2017)
Code
ME4
Topic
Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Public Health
Disease
Diabetes/Endocrine/Metabolic Disorders