Cost of Type 2 Diabetes Patients with Chronic Kidney Disease Based on Real-World Data: An Observational Population-Based Study in Spain
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Sources
2.3. Study Population
2.4. Cost Analysis
2.5. Statistical Analysis
3. Results
3.1. Population Characteristics
3.2. Use of Healthcare Resources
3.3. Costs in Each KDIGO Category and Distribution of Costs
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- International Diabetes Federation. IDF Diabetes Atlas, 9th ed.; International Diabetes Federation: Brussels, Belgium, 2019; Available online: www.diabetesatlas.org (accessed on 11 May 2021).
- Shaw, J.E.; Sicree, R.A.; Zimmet, P.Z. Global Estimates of the Prevalence of Diabetes for 2010 and 2030. Diabetes Res Clin. Pract. 2010, 87, 4–14. [Google Scholar] [CrossRef]
- Soriguer, F.; Goday, A.; Bosch-Comas, A.; Bordiú, E.; Calle-Pascual, A.; Carmena, R.; Casamitjana, R.; Castaño, L.; Castell, C.; Catalá, M.; et al. Prevalence of Diabetes Mellitus and Impaired Glucose Regulation in Spain: The [email protected] Study. Diabetologia 2012, 55, 88–93. [Google Scholar] [CrossRef] [Green Version]
- Inoriza, J.M.; Pérez, M.; Cols, M.; Sánchez, I.; Carreras, M.; Coderch, J. An analysis of the diabetic population in a Spanish rural are: Morbidity profile, use of resources, complications and metabolic control. Aten. Primaria 2013, 45, 461–475. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Giralt Muiña, P.; Gutiérrez Ávila, G.; Ballester Herrera, M.J.; Botella Romero, F.; Angulo Donado, J.J.; Grupo de Epidemiología de Diabetes de Castilla-La Mancha (GEDCAM). Prevalence of known diabetes mellitus and unknown diabetes in adults from Castilla-La Mancha, Spain. Med. Clin. 2011, 137, 484–490. [Google Scholar] [CrossRef]
- Hsu, R.K.; Powe, N.R. Recent Trends in the Prevalence of Chronic Kidney Disease: Not the Same Old Song. Curr. Opin. Nephrol. Hypertens. 2017, 26, 187–196. [Google Scholar] [CrossRef]
- Rodriguez-Poncelas, A.; Garre-Olmo, J.; Franch-Nadal, J.; Diez-Espino, J.; Mundet-Tuduri, X.; Barrot-De la Puente, J.; Coll-de Tuero, G. RedGDPS Study Group Prevalence of Chronic Kidney Disease in Patients with Type 2 Diabetes in Spain: PERCEDIME2 Study. BMC Nephrol. 2013, 14, 46. [Google Scholar] [CrossRef] [Green Version]
- Coll-de-Tuero, G.; Mata-Cases, M.; Rodriguez-Poncelas, A.; Pepió, J.M.; Roura, P.; Benito, B.; Franch-Nadal, J.; Saez, M. Chronic Kidney Disease in the Type 2 Diabetic Patients: Prevalence and Associated Variables in a Random Sample of 2642 Patients of a Mediterranean Area. BMC Nephrol. 2012, 13, 87. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mata-Cases, M.; Franch-Nadal, J.; Real, J.; Cedenilla, M.; Mauricio, D. Prevalence and Coprevalence of Chronic Comorbid Conditions in Patients with Type 2 Diabetes in Catalonia: A Population-Based Cross-Sectional Study. BMJ Open 2019, 9, e031281. [Google Scholar] [CrossRef] [PubMed]
- Martínez Candela, J.; Sangrós González, J.; García Soidán, F.J.; Millaruelo Trillo, J.M.; Díez Espino, J.; Bordonaba Bosque, D.; Ávila Lachica, L. En representación del Grupo de Atención Primaria y Prediabetes de la Sociedad Española de Diabetes. Chronic Renal Disease in Spain: Prevalence and Related Factors in Persons with Diabetes Mellitus Older than 64 Years. Nefrologia 2018, 38, 401–413. [Google Scholar] [CrossRef] [PubMed]
- Winocour, P.H. Diabetes and Chronic Kidney Disease: An Increasingly Common Multi-Morbid Disease in Need of a Paradigm Shift in Care. Diabet. Med. 2018, 35, 300–305. [Google Scholar] [CrossRef] [PubMed]
- Adler, A.I.; Stevens, R.J.; Manley, S.E.; Bilous, R.W.; Cull, C.A.; Holman, R.R. UKPDS GROUP Development and Progression of Nephropathy in Type 2 Diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int. 2003, 63, 225–232. [Google Scholar] [CrossRef] [Green Version]
- Nag, S.; Bilous, R.; Kelly, W.; Jones, S.; Roper, N.; Connolly, V. All-Cause and Cardiovascular Mortality in Diabetic Subjects Increases Significantly with Reduced Estimated Glomerular Filtration Rate (EGFR): 10 Years’ Data from the South Tees Diabetes Mortality Study. Diabet Med. 2007, 24, 10–17. [Google Scholar] [CrossRef]
- Mahillo, B. 2019 Report, Renal Patients Registry. Available online: www.registrorenal.es (accessed on 10 February 2021).
- López-Bastida, J.; Boronat, M.; Moreno, J.O.; Schurer, W. Costs, Outcomes and Challenges for Diabetes Care in Spain. Glob. Health 2013, 9, 17. [Google Scholar] [CrossRef] [Green Version]
- Crespo, C.; Brosa, M.; Soria-Juan, A.; Lopez-Alba, A.; López-Martínez, N.; Soria, B. Costes directos de la diabetes mellitus y de sus complicaciones en España (Estudio SECCAID: Spain estimated cost Ciberdem-Cabimer in Diabetes). Av. Diabetol. 2013, 29, 182–189. [Google Scholar] [CrossRef] [Green Version]
- López-de-Andrés, A.; Carrasco-Garrido, P.; Esteban-Hernandez, J.; Gil-de-Miguel, A.; Jiménez-García, R. Characteristics and Hospitalization Costs of Patients with Diabetes in Spain. Diabetes Res. Clin. Pract. 2010, 89, e2–e4. [Google Scholar] [CrossRef]
- Paz, S.; González Segura, D.; Raya Torres, A.; Lizan, L. Principales factores asociados al coste de la diabetes mellitus tipo 2: Revisión de la literatura. Av. Diabetol. 2014, 30, 34–44. [Google Scholar] [CrossRef] [Green Version]
- Alonso-Morán, E.; Satylganova, A.; Orueta, J.F.; Nuño-Solinis, R. Prevalence of Depression in Adults with Type 2 Diabetes in the Basque Country: Relationship with Glycaemic Control and Health Care Costs. BMC Public Health 2014, 14, 769. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Vivas-Consuelo, D.; Alvis-Estrada, L.; Uso-Talamantes, R.; Caballer-Tarazona, V.; Buigues-Pastor, L.; Sancho-Mestre, C. Multimorbidity Pharmaceutical Cost of Diabetes Mellitus. Value Health 2014, 17, A341–A342. [Google Scholar] [CrossRef] [Green Version]
- Arrieta, F.; Rubio-Terrés, C.; Rubio-Rodríguez, D.; Magaña, A.; Piñera, M.; Iglesias, P.; Nogales, P.; Calañas, A.; Novella, B.; Botella-Carretero, J.I.; et al. Estimation of the Economic and Health Impact of Complications of Type 2 Diabetes Mellitus in the Autonomous Community of Madrid (Spain). Endocrinol. Nutr. 2014, 61, 193–201. [Google Scholar] [CrossRef] [PubMed]
- Mata-Cases, M.; Casajuana, M.; Franch-Nadal, J.; Casellas, A.; Castell, C.; Vinagre, I.; Mauricio, D.; Bolíbar, B. Direct Medical Costs Attributable to Type 2 Diabetes Mellitus: A Population-Based Study in Catalonia, Spain. Eur. J. Health Econ. 2016, 17, 1001–1010. [Google Scholar] [CrossRef] [Green Version]
- Nuño-Solinís, R.; Alonso-Morán, E.; Arteagoitia Axpe, J.M.; Ezkurra Loiola, P.; Orueta, J.F.; Gaztambide, S. Healthcare Costs of People with Type 2 Diabetes Mellitus in the Basque Country (Spain). Endocrinol. Nutr. 2016, 63, 543–550. [Google Scholar] [CrossRef] [PubMed]
- Sancho-Mestre, C.; Vivas-Consuelo, D.; Alvis-Estrada, L.; Romero, M.; Usó-Talamantes, R.; Caballer-Tarazona, V. Pharmaceutical Cost and Multimorbidity with Type 2 Diabetes Mellitus Using Electronic Health Record Data. BMC Health Serv. Res. 2016, 16, 394. [Google Scholar] [CrossRef] [Green Version]
- Alvis Estrada, L.; Vivas-Consuelo, D.; Caballer-Tarazona, V.; Usó-Talamantes, R.; Sancho-Mestre, C.; Buigues-Pastor, L. Gasto Farmacéutico En Diabetes Mellitus En Una Región de España Según El Clinical Risk Group, 2012. RGYPS 2016, 15, 68–78. [Google Scholar] [CrossRef] [Green Version]
- Vupputuri, S.; Kimes, T.M.; Calloway, M.O.; Christian, J.B.; Bruhn, D.; Martin, A.A.; Nichols, G.A. The Economic Burden of Progressive Chronic Kidney Disease among Patients with Type 2 Diabetes. J. Diabetes Complicat. 2014, 28, 10–16. [Google Scholar] [CrossRef] [PubMed]
- McQueen, R.B.; Farahbakhshian, S.; Bell, K.F.; Nair, K.V.; Saseen, J.J. Economic Burden of Comorbid Chronic Kidney Disease and Diabetes. J. Med. Econ. 2017, 20, 585–591. [Google Scholar] [CrossRef] [PubMed]
- Lage, M.J.; Boye, K.S.; Bae, J.P.; Wu, J.; Mody, R.; Botros, F.T. The Association between the Severity of Chronic Kidney Disease and Medical Costs among Patients with Type 2 Diabetes. J. Med. Econ. 2019, 22, 447–454. [Google Scholar] [CrossRef] [PubMed]
- Low, S.; Lim, S.C.; Zhang, X.; Wang, J.; Yeo, S.J.D.; Yeoh, L.Y.; Liu, Y.L.; Subramaniam, T.; Sum, C.F. Medical Costs Associated with Chronic Kidney Disease Progression in an Asian Population with Type 2 Diabetes Mellitus. Nephrology 2019, 24, 534–541. [Google Scholar] [CrossRef] [PubMed]
- Levin, A.; Stevens, P.E.; Bilous, R.W.; Coresh, J.; de Francisco, A.L.M.; de Long, P.E. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Gorup. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. Suppl. 2013, 3, 5–14. [Google Scholar]
- Hughes, J.S.; Averill, R.F.; Eisenhandler, J.; Goldfield, N.I.; Muldoon, J.; Neff, J.M.; Gay, J.C. Clinical Risk Groups (CRGs): A Classification System for Risk-Adjusted Capitation-Based Payment and Health Care Management. Med. Care 2004, 42, 81–90. [Google Scholar] [CrossRef]
- Vivas-Consuelo, D.; Usó-Talamantes, R.; Trillo-Mata, J.L.; Caballer-Tarazona, M.; Barrachina-Martínez, I.; Buigues-Pastor, L. Predictability of Pharmaceutical Spending in Primary Health Services Using Clinical Risk Groups. Health Policy 2014, 116, 188–195. [Google Scholar] [CrossRef]
- De Francisco, A.L.M. Sustainability and Equity of Renal Replacement Therapy in Spain. Nefrologia 2011, 31, 241–246. [Google Scholar] [CrossRef] [PubMed]
- Gerstein, H.C.; Colhoun, H.M.; Dagenais, G.R.; Diaz, R.; Lakshmanan, M.; Pais, P.; Probstfield, J.; Riddle, M.C.; Rydén, L.; Xavier, D.; et al. Design and Baseline Characteristics of Participants in the Researching Cardiovascular Events with a Weekly INcretin in Diabetes (REWIND) Trial on the Cardiovascular Effects of Dulaglutide. Diabetes Obes. Metab. 2018, 20, 42–49. [Google Scholar] [CrossRef] [Green Version]
- Kramer, H.J.; Nguyen, Q.D.; Curhan, G.; Hsu, C.-Y. Renal Insufficiency in the Absence of Albuminuria and Retinopathy among Adults with Type 2 Diabetes Mellitus. JAMA 2003, 289, 3273–3277. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ninomiya, T.; Perkovic, V.; de Galan, B.E.; Zoungas, S.; Pillai, A.; Jardine, M.; Patel, A.; Cass, A.; Neal, B.; Poulter, N.; et al. Albuminuria and Kidney Function Independently Predict Cardiovascular and Renal Outcomes in Diabetes. J. Am. Soc. Nephrol. 2009, 20, 1813–1821. [Google Scholar] [CrossRef]
- National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification. Am. J. Kidney Dis. 2002, 39, S1-266. [Google Scholar]
- Barnett, K.; Mercer, S.W.; Norbury, M.; Watt, G.; Wyke, S.; Guthrie, B. Epidemiology of Multimorbidity and Implications for Health Care, Research, and Medical Education: A Cross-Sectional Study. Lancet 2012, 380, 37–43. [Google Scholar] [CrossRef] [Green Version]
- Calderón-Larrañaga, A.; Abad-Díez, J.M.; Gimeno-Feliu, L.A.; Marta-Moreno, J.; González-Rubio, F.; Clerencia-Sierra, M.; Poblador-Plou, B.; Poncel-Falcó, A.; Prados-Torres, A. Global Health Care Use by Patients with Type-2 Diabetes: Does the Type of Comorbidity Matter? Eur. J. Intern. Med. 2015, 26, 203–210. [Google Scholar] [CrossRef] [PubMed]
- Klompas, M.; Eggleston, E.; McVetta, J.; Lazarus, R.; Li, L.; Platt, R. Automated Detection and Classification of Type 1 Versus Type 2 Diabetes Using Electronic Health Record Data. Diabetes Care 2013, 36, 914–921. [Google Scholar] [CrossRef] [Green Version]
- Teljeur, C.; Smith, S.M.; Paul, G.; Kelly, A.; O’Dowd, T. Multimorbidity in a Cohort of Patients with Type 2 Diabetes. Eur. J. Gen. Pract. 2013, 19, 17–22. [Google Scholar] [CrossRef] [PubMed]
- Prados-Torres, A.; Poblador-Plou, B.; Calderón-Larrañaga, A.; Gimeno-Feliu, L.A.; González-Rubio, F.; Poncel-Falcó, A.; Sicras-Mainar, A.; Alcalá-Nalvaiz, J.T. Multimorbidity Patterns in Primary Care: Interactions among Chronic Diseases Using Factor Analysis. PLoS ONE 2012, 7, e32190. [Google Scholar] [CrossRef] [Green Version]
- Parra Moncasi, E.; Arenas Jiménez, M.D.; Alonso, M.; Martínez, M.F.; Gámen Pardo, A.; Rebollo, P.; Ortega Montoliú, T. Estudio multicéntrico de costes en hemodiálisis. Nefrología 2011, 31, 299–307. [Google Scholar] [CrossRef] [PubMed]
- De Boer, I.H.; Caramori, M.L.; Chan, J.C.N.; Heerspink, H.J.L.; Hurst, C.; Khunti, K.; Liew, A.; Michos, E.D.; Navaneethan, S.D.; Olowu, W.A.; et al. Executive summary of the 2020 KDIGO Diabetes Management in CKD Guideline: Evidence-based advances in monitoring and treatment. Kidney Int. 2020, 98, 839–848. [Google Scholar] [CrossRef] [PubMed]
- Snider, J.T.; Sullivan, J.; van Eijndhoven, E.; Hansen, M.K.; Bellosillo, N.; Neslusan, C.; O’Brien, E.; Riley, R.; Seabury, S.; Bertram, L.K. Lifetime benefits of early detection and treatment of diabetic kidney disease. PLoS ONE 2019, 14, e0217487. [Google Scholar] [CrossRef]
Main Health State (CRG) | n (%) | Age, Years, Mean (SD) | Gender, Male (%) | eGFR a, Mean (SD) |
---|---|---|---|---|
1. Healthy | 67 (0.5) | 46.7 (14.8) | 35.8 | 104.9 (19.7) |
2. Significant acute disease | 22 (0.2) | 51.6 (14.0) | 68.2 | 101.0 (19.4) |
3. Single minor chronic disease | 99 (0.7) | 54.5 (14.4) | 39.4 | 95.6 (20.0) |
4. Minor chronic disease in multiple organ systems | 97 (0.7) | 59.4 (15.3) | 32.0 | 92.3 (18.1) |
5. Single moderate dominant or chronic disease | 3.980 (26.7) | 62.1 (13.9) | 58.7 | 88.2 (18.1) |
6. Significant chronic disease in multiple organ systems | 8.438 (56.5) | 70.0 (11.5) | 49.8 | 77.0 (21.1) |
7. Dominant chronic disease in three or more organ systems | 1.759 (11.8) | 75.1 (9.6) | 54.4 | 67.0 (22.4) |
8. Dominant neoplasms, metastases and complications | 200 (1.3) | 71.1 (9.9) | 66.0 | 73.6 (24.8) |
9. Severe diseases or extreme healthcare needs | 55 (0.4) | 62.8 (13.4) | 60.0 | 75.6 (33.3) |
Unclassified | 218 (1.5) | 77.1 (12.9) | 54.4 | 56.3 (28.1) |
Albuminuria | |||||||
A1 | A2 | A3 | |||||
Normal to mildly increased | Moderately increased | Severely increased | |||||
<30 mg/g | 30–300 mg/g | ≥300 mg/g | Total | ||||
eGFR | G1 | Normal or high | >90 | 4508 (30.2) | 688 (4.6) | 45 (0.3) | 5241 (35.1) |
G2 | Mildly decreased | 60–89 | 5377 (36.0) | 1210 (8.1) | 113 (0.8) | 6700 (44.9) | |
G3a | Mildly to moderately decreased | 45–59 | 1183 (7.9) | 458 (3.1) | 62 (0.4) | 1703 (11.4) | |
G3b | Moderately to severely decreased | 30–44 | 570 (3.8) | 323 (2.2) | 75 (0.5) | 968 (6.5) | |
G4 | Severely decreased | 15–29 | 113 (0.8) | 134 (0.9) | 40 (0.3) | 287 (1.9) | |
G5 | Kidney failure | <15 | 6 (0.04) | 17 (0.1) | 13 (0.1) | 36 (0.2) | |
Total | 11,757 (78.7) | 2830 (19.0) | 348 (2.3) | 14,935 (100) |
Resource | KDIGO Category | Total | |||
---|---|---|---|---|---|
Low | Moderately Increased | Highly Increased | Very Highly Increased | ||
Use of resources (mean/patient) | |||||
Primary care consultations | 17.45 | 21.11 | 25.00 | 27.28 | 19.32 |
Outpatient consultations | 3.82 | 4.63 | 5.14 | 6.02 | 4.21 |
Hospital admissions | 0.21 | 0.34 | 0.43 | 0.57 | 0.27 |
ER admissions | 0.54 | 0.76 | 0.97 | 1.17 | 0.65 |
Costs (EUR, mean/patient) | |||||
Outpatient consultations | 170 | 206 | 228 | 268 | 187 |
Hospital admissions | 875 | 1560 | 1950 | 2689 | 1197 |
Emergency room | 102 | 144 | 184 | 221 | 124 |
Laboratory | 135 | 173 | 228 | 347 | 162 |
Imaging | 226 | 343 | 395 | 545 | 280 |
Pharmaceutical | 1133 | 1540 | 1770 | 1895 | 1308 |
Albuminuria | |||||||
A1 | A2 | A3 | |||||
Normal to mildly increased | Moderately increased | Severely increased | |||||
<30 mg/g | 30–300 mg/g | ≥300 mg/g | Total | ||||
eGFR | G1 | Normal or high | >90 | 3217 (3097–3336) | 4816 (4323–5309) | 6281 (3726–8,837) | 3453 (3328–3577) |
G2 | Mildly decreased | 60–89 | 3622 (3511–3733) | 5228 (4893–5562) | 6302 (4888–7716) | 3957 (3846–4069) | |
G3a | Mildly to moderately decreased | 45–59 | 4708 (4401–5015) | 6000 (5424–6576) | 6002 (4310–7695) | 5103 (4830–5375) | |
G3b | Moderately to severely decreased | 30–44 | 5708 (5163–6253) | 6354 (5697–7011) | 6046 (4700–7391) | 5949 (5547–6352) | |
G4 | Severely decreased | 15–29 | 7859 (6420–9299) | 8461 (7008–9913) | 7623 (5271–9976) | 8107 (7167–9048) | |
G5 | Kidney failure | <15 | 12,281 (9553–15,009) | 14,899 (9220–20,578) | 19,532 (10,675–28,389) | 16,136 (11,933–20,338) | |
Total | 3722 (3640–3804) | 5592 (5355–5830) | 6837 (5980–7694) | 4149 (4067–4231) | |||
Mean total costs per KDIGO category | 3437 | 4936 | 5899 | 7389 | 4149 |
CRG | Severity | Unclassified | Total | |||||||
---|---|---|---|---|---|---|---|---|---|---|
0 | 1 | 2 | 3 | 4 | 5 | 6 | ||||
1. Healthy | n | 10 | 3 | 26 | - | 5 | 23 | - | - | 67 |
Total costs | 3356 | 858 | 117,558 | - | 23,711 | 13,256 | - | - | 158,739 | |
Mean costs | 335.6 | 286.0 | 4521.5 | - | 4742.3 | 576.3 | - | - | 2369.2 | |
2. Significant acute disease | n | 1 | - | 3 | - | 3 | 15 | - | - | 22 |
Total costs | 756 | - | 11,575 | - | 8005 | 20,784 | - | - | 41,120 | |
Mean costs | 755.8 | - | 3858.2 | - | 2668.3 | 1385.6 | - | - | 1869.1 | |
3. Single minor chronic disease | n | - | 85 | 14 | - | - | - | - | - | 99 |
Total costs | - | 86,091 | 72,635 | - | - | - | - | - | 158,726 | |
Mean costs | - | 1012.8 | 5188.2 | - | - | - | - | - | 1603.3 | |
4. Minor chronic disease in multiple organ systems | n | - | 38 | 33 | 25 | 1 | - | - | - | 97 |
Total costs | - | 64,459 | 54,951 | 113,189 | 1191 | - | - | - | 233,689 | |
Mean costs | - | 1696.3 | 1662.1 | 4527.6 | 1191.0 | - | - | - | 2409.2 | |
5. Single moderate dominant or chronic disease | n | - | 2017 | 1,034 | 668 | 4 | 256 | 1 | - | 3980 |
Total costs | - | 3,346,092 | 2,594,747 | 1,731,109 | 16,455 | 873,560 | 6154 | - | 8,568,118 | |
Mean costs | - | 1658.9 | 2509.4 | 2591.5 | 4113.6 | 3412.3 | 6154.2 | - | 2152.8 | |
6. Significant chronic disease in multiple organ systems | n | - | 3013 | 1887 | 1614 | 1236 | 637 | 51 | - | 8438 |
Total costs | - | 8,142,056 | 7,104,401 | 7,038,780 | 6,990,556 | 4,814,589 | 851,524 | - | 34,941,906 | |
Mean costs | - | 2702.3 | 3764.9 | 4361.1 | 5655.8 | 7558.2 | 16,696.6 | - | 4141.0 | |
7. Dominant chronic disease in three or more organ systems | n | - | 437 | 269 | 738 | 191 | 86 | 38 | - | 1759 |
Total costs | - | 1,788,498 | 1,696,738 | 5,242,343 | 1,887,398 | 1,318,127 | 780,125 | - | 12,713,229 | |
Mean costs | - | 4092.7 | 6307.6 | 7103.4 | 9881.7 | 15,327.1 | 20,529.6 | - | 7227.5 | |
8. Dominant neoplasms. metastases and complications | n | - | 1 | 39 | 78 | 67 | 15 | - | - | 200 |
Total costs | - | 2168 | 231,990 | 816,129 | 1,129,333 | 248,583 | - | - | 2,428,203 | |
Mean costs | - | 2168.3 | 5948.5 | 10,463.2 | 16,855.7 | 16,572.2 | - | - | 12,141.0 | |
9. Severe diseases or extreme healthcare needs | n | - | 4 | 23 | 6 | 16 | 4 | 2 | - | 55 |
Total costs | - | 24,315 | 165,223 | 78,784 | 150,827 | 77,749 | 87,849 | - | 584,478 | |
Mean costs | - | 6078.9 | 7183.6 | 13,130.7 | 9426.7 | 19,369.8 | 43,924.4 | - | 10,626.9 | |
Total | n | 11 | 5598 | 3328 | 3129 | 1523 | 1036 | 92 | 218 | 14,935 |
Total costs | 4112 | 13,454,538 | 12,049,717 | 15,020,335 | 10,207,475 | 7,366,379 | 1,725,652 | 2,139,499 | 61,967,707 | |
Mean costs | 373.8 | 2403.5 | 3620.7 | 4800.4 | 6702.2 | 7110.4 | 18,757.1 | 9814.2 | 4149.2 |
Variable | Regression Coefficient (SE) |
---|---|
Constant | 5.881 (0.229) * |
CRG 4. Minor chronic disease in multiple organ systems | 0.466 (0.092) * |
CRG 5. Single moderate dominant or chronic disease | 0.433 (0.056) * |
CRG 6. Significant chronic disease in multiple organ systems | 0.896 (0.055) * |
CRG 7. Dominant chronic disease in three or more organ systems | 1.382 (0.058) * |
CRG 8. Dominant neoplasms, metastases and complications | 1.700 (0.075) * |
CRG 9. Severe diseases or extreme healthcare needs | 1.409 (0.113) * |
Severity 1 | 0.845 (0.235) * |
Severity 2 | 1.213 (0.235) * |
Severity 3 | 1.333 (0.236) * |
Severity 4 | 1.586 (0.236) * |
Severity 5 | 1.730 (0.236) * |
Severity 6 | 2.554 (0.247) * |
eGFR G5 | 0.504 (0.135) * |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Usó-Talamantes, R.; González-de-Julián, S.; Díaz-Carnicero, J.; Saurí-Ferrer, I.; Trillo-Mata, J.L.; Carrasco-Pérez, M.; Navarro-Pérez, J.; Górriz, J.L.; Vivas-Consuelo, D.; Redón, J. Cost of Type 2 Diabetes Patients with Chronic Kidney Disease Based on Real-World Data: An Observational Population-Based Study in Spain. Int. J. Environ. Res. Public Health 2021, 18, 9853. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189853
Usó-Talamantes R, González-de-Julián S, Díaz-Carnicero J, Saurí-Ferrer I, Trillo-Mata JL, Carrasco-Pérez M, Navarro-Pérez J, Górriz JL, Vivas-Consuelo D, Redón J. Cost of Type 2 Diabetes Patients with Chronic Kidney Disease Based on Real-World Data: An Observational Population-Based Study in Spain. International Journal of Environmental Research and Public Health. 2021; 18(18):9853. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189853
Chicago/Turabian StyleUsó-Talamantes, Ruth, Silvia González-de-Julián, Javier Díaz-Carnicero, Inmaculada Saurí-Ferrer, José Luis Trillo-Mata, Marc Carrasco-Pérez, Jorge Navarro-Pérez, José Luis Górriz, David Vivas-Consuelo, and Josep Redón. 2021. "Cost of Type 2 Diabetes Patients with Chronic Kidney Disease Based on Real-World Data: An Observational Population-Based Study in Spain" International Journal of Environmental Research and Public Health 18, no. 18: 9853. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189853