Insights for Care: The Healthcare Utilisation and Cost Impact of Managing Type 2 Diabetes-Associated Microvascular Complications.

Chapman, David and Foxcroft, Roland and Dale-Harris, Laura and Ronte, Hanno and Bidgoli, Farid and Bellary, Srikanth (2019) Insights for Care: The Healthcare Utilisation and Cost Impact of Managing Type 2 Diabetes-Associated Microvascular Complications. Diabetes therapy : research, treatment and education of diabetes and related disorders. ISSN 1869-6953. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://link.springer.com/article/10.1007%2Fs13300...

Abstract

INTRODUCTION

The increasing prevalence of type 2 diabetes (T2DM) in the UK imposes a significant burden on the National Health Service (NHS). Despite the availability of effective treatments, the loss of glycaemic control over time results in significant comorbidities, including nephropathy, neuropathy and retinopathy. The cost of treating these microvascular complications has not been well documented, and this study aimed to provide an accurate assessment of the healthcare resource utilisation (HCRU) associated with managing T2DM and its complications.

METHODS

This retrospective cohort study utilised electronic medical records from patients with T2DM from the Heart of England Foundation Trust (HEFT), which captures data from patients using secondary care services. Patients were diagnosed with microvascular complications based on ICD-10 or OPCS codes. HCRU over a 2-year period was based on NHS Tariffs for healthcare services for inpatient, accident and emergency, and dialysis clinic usage.

RESULTS

The study cohort comprised 26,629 patients with T2DM who used HEFT services during the study period, 22.6%, 20.8% and 3.1% of whom had comorbid nephropathy, retinopathy or neuropathy, respectively. While the prevalence of diabetes in the overall HEFT population was reported to be 7% in 2012, diabetes and its associated complications accounted for more than 30% of secondary care costs. Furthermore, while patients with diabetes represent only 17% of HEFT inpatients, they account for more than 20% of service usage. The economic burden of microvascular complications increased substantially with the severity of the condition, with the overall cost exceeding £70 million over the 2-year period.

CONCLUSION

This study of patients with T2DM in a typical secondary care provider in the UK showed that avoiding the progression of microvascular complications could provide substantial cost savings through targeted interventions that improve outcomes and lower resource use.

FUNDING

Merck Sharp & Dohme Limited.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WK Endocrine system. Endocrinology
Divisions: Ambulatory Care > Diabetes
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Depositing User: Mr Philip O'Reilly
Date Deposited: 19 Mar 2019 12:21
Last Modified: 19 Mar 2019 12:21
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1937

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