Norhammar, Anna;
Bodegard, Johan;
Eriksson, Jan W;
Hermann, Haller;
Linssen, Gerard CM;
Banerjee, Amitava;
Karasik, Avraham;
... CaReMe Cardiorenal Investigators, .; + view all
(2022)
Cost of healthcare utilization associated with incident cardiovascular and renal disease in individuals with type 2 diabetes: a multinational, observational study across 12 countries.
Diabetes, Obesity and Metabolism
10.1111/dom.14698.
(In press).
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Abstract
BACKGROUND: Cardiorenal disease (heart failure [HF] or chronic kidney disease [CKD]) is associated with increased mortality in type 2 diabetes (T2D) individuals. We examined how the development of cardiovascular and renal disease (CVRD) translates to hospital health care costs in persons with T2D, initially free from CVRD. METHODS: Data were obtained from the digital health care systems of 12 nations using a prespecified protocol. A fixed country-specific index date of January 1st was chosen to secure sufficient cohort disease history and maximal follow-up, varying between each nation from 2006 to 2017. At index, all persons were free from any diagnoses of CVRD (including HF, CKD, coronary ischemic disease, stroke, myocardial infarction [MI] or peripheral artery disease [PAD]). Outcomes during follow-up were hospital visits for CKD, HF, MI, stroke and PAD. Hospital health care costs obtained from six countries, representing 68% of the total study population, were cumulatively summarized for CVRD events occurring during follow-up. RESULTS: 1.2 million CVRD-free persons with T2D were identified and followed for 4.5 years (mean); 4.9 million patient-years. The proportion of persons indexed before 2010 was 18% (n=207,137); 2010-2015, 31% (361,175); and after 2015, 52% (609,095). 184,420 (15.7%) developed CVRD, of which cardiorenal disease was most frequently the first disease to develop (59.7%); consisting of 23.0% HF and 36.7% CKD; and more common than stroke (16.9%), MI (13.7%) and PAD (9.7%). The total cumulative cost for CVRD was $1 billion, of which 59.0% was attributed to cardiorenal disease; three-, five-, and six-fold times greater than the costs for stroke, MI and PAD, respectively. CONCLUSION: Across all nations, HF or CKD were most frequent CVRD manifestation to develop in a low-risk population with T2D; accounting for the highest proportion of hospital health care costs. These novel findings highlight the importance of cardiorenal awareness when planning health care. This article is protected by copyright. All rights reserved.
| Type: | Article |
|---|---|
| Title: | Cost of healthcare utilization associated with incident cardiovascular and renal disease in individuals with type 2 diabetes: a multinational, observational study across 12 countries |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/dom.14698 |
| Publisher version: | https://doi.org/10.1111/dom.14698 |
| Language: | English |
| Additional information: | This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in anymedium, provided the original work is properly cited and is not used for commercial purposes. Copyright © 2022 The Authors. |
| Keywords: | CaReMe Cardiorenal Investigators |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10145913 |
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