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

David Chapman, Roland Foxcroft, Laura Dale-Harris, Hanno Ronte, Farid Bidgoli, Srikanth Bellary*

*Corresponding author for this work

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)575-585
Number of pages11
JournalDiabetes Therapy
Volume10
Issue number2
DOIs
Publication statusPublished - 1 Apr 2019

Fingerprint

Health Care Costs
Type 2 Diabetes Mellitus
England
Secondary Care
National Health Programs
Delivery of Health Care
Costs and Cost Analysis
Inpatients
Cohort Studies
Cost Savings
Electronic Health Records
International Classification of Diseases
Accidents
Comorbidity
Dialysis
Emergencies
Retrospective Studies
Economics
Population

Bibliographical note

© The Author(s) 2019

Keywords

  • Diabetic complications
  • Healthcare resource utilisation
  • Insights for care
  • Microvascular complications
  • Nephropathy
  • Neuropathy
  • Real world data
  • Retinopathy
  • Type 2 diabetes

Cite this

Chapman, David ; Foxcroft, Roland ; Dale-Harris, Laura ; Ronte, Hanno ; Bidgoli, Farid ; Bellary, Srikanth. / Insights for Care : The Healthcare Utilisation and Cost Impact of Managing Type 2 Diabetes-Associated Microvascular Complications. In: Diabetes Therapy. 2019 ; Vol. 10, No. 2. pp. 575-585.
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Insights for Care : The Healthcare Utilisation and Cost Impact of Managing Type 2 Diabetes-Associated Microvascular Complications. / Chapman, David; Foxcroft, Roland; Dale-Harris, Laura; Ronte, Hanno; Bidgoli, Farid; Bellary, Srikanth.

In: Diabetes Therapy, Vol. 10, No. 2, 01.04.2019, p. 575-585.

Research output: Contribution to journalArticle

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T2 - The Healthcare Utilisation and Cost Impact of Managing Type 2 Diabetes-Associated Microvascular Complications

AU - Chapman, David

AU - Foxcroft, Roland

AU - Dale-Harris, Laura

AU - Ronte, Hanno

AU - Bidgoli, Farid

AU - Bellary, Srikanth

N1 - © The Author(s) 2019

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AB - 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.

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