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Predictors of direct costs of diabetes care in pediatric patients with type 1 diabetes.
MedLine Citation:
PMID:  20807368     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: This study examines factors that predict elevated direct costs of pediatric patients with type 1 diabetes.
METHODS: A cohort of 784 children with type 1 diabetes at least 6 months postdiagnosis and managed by pediatric endocrinologists at Texas Children's Hospital were included in this study. Actual reimbursed costs from January 2004 to December 2005 were obtained. Medication and supply costs were based on estimates from insulin dosage and type of insulin regimen prescribed, respectively. We examined utilization of care, total diabetes-related direct medical costs, and predictors of direct costs and hospitalization.
RESULTS: Annually, 7% (58/784) of patients (excluding initial hospitalization at diagnosis) had a diabetes-related hospitalization and median length of stay was days. Mean total diabetes-related direct cost per person-year was $4730 [95% confidence interval (CI), 4516-4944]. Supplies accounted for 38% and medications 33% of costs, respectively. Older age, hemoglobin A(1C) (HbA(1C) ) > 8.5%, use of a multi-injection or pump regimen, living in a non-married household, and female gender were associated with higher annual costs. HbA(1C) > 8.5%, living in a non-married household, and female gender increased the odds of a diabetes-related hospitalization.
DISCUSSION: Better metabolic control in patients with type 1 diabetes was associated with lower direct medical costs and lower odds of hospitalization. Marital status of the primary caregiver, irrespective of type of insurance, impacts the patient's healthcare costs and risk of hospitalization. This large single-center US study analyzes cost distribution in children with diabetes and is informative for payers and providers focused on effective management and improving healthcare costs.
Authors:
Anita K Ying; David R Lairson; Angelo P Giardino; Melissa L Bondy; Irum Zaheer; Morey W Haymond; Rubina A Heptulla
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Publication Detail:
Type:  Journal Article     Date:  2010-08-30
Journal Detail:
Title:  Pediatric diabetes     Volume:  12     ISSN:  1399-5448     ISO Abbreviation:  Pediatr Diabetes     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100939345     Medline TA:  Pediatr Diabetes     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  177-82     Citation Subset:  IM    
Copyright Information:
© 2010 John Wiley & Sons A/S.
Affiliation:
Department of Endocrine Neoplasia and Hormonal Disorders and Division of Pediatrics UTMD Anderson Cancer Center, Houston, TX, USA.
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