Direct medical cost of diabetes in rural China using electronic insurance claims data and diabetes management data

Abstract Aims/Introduction To evaluate the annual direct medical cost attributable to type 2 diabetes mellitus according to socioeconomic factors, medical conditions and complications categories. Materials and Methods We created uniquely detailed data from merging datasets of the local diabetes management system and the social security system in Tongxiang, China. We calculated the type 2 diabetes mellitus‐related total cost and out‐of‐pocket cost for inpatient admissions and outpatient visits, and compared the cost for patients with or without complications by different healthcare items. Results A total of 16,675 patients were eligible for analysis. The type 2 diabetes mellitus‐related cost accounted for 40.6% of the overall cost. The cost per patient was estimated to be a median of 1,067 Chinese Yuan, 7,114 Chinese Yuan and 969 Chinese Yuan for inpatient and outpatient cost, respectively. The median total cost for hospital‐based care was 3.69‐fold higher than that for primary care. The median cost of patients with complications was 3.46‐fold higher than that of those without complications. The median cost for a patient with only macrovascular, only microvascular or both macrovascular and microvascular complications were 3.13‐, 3.79‐ and 10.95‐fold higher than that of patients without complications. Pharmaceutical expenditure accounted for 51.8 and 79.7% of the total cost for patients with or without complications, respectively. Conclusions Although the type 2 diabetes mellitus‐related cost per patient was relatively low, it accounted for a great proportion of the overall cost. Complications obviously aggravated the economic burden of type 2 diabetes mellitus. Proper management and the prevention of diabetes and its complications are urgently required to curtail the economic burden