The cost of cardiovascular-disease-related death in patients with type 2 diabetes mellitus

Curr Med Res Opin. 2018 Jun;34(6):1081-1087. doi: 10.1080/03007995.2018.1445620. Epub 2018 Mar 29.

Abstract

Objectives: To assess the magnitude of difference in all-cause healthcare resource utilization (HCRU) and costs between patients with type 2 diabetes mellitus (T2DM) who died from a cardiovascular disease (CVD)-related cause in the year preceding death vs. those who did not die during this same period.

Methods: A large US administrative claims database was used to identify patients with T2DM who died of a CVD-related cause from July 2012 to April 2015. These patients were matched 1:1 to patients with T2DM who did not die, using direct matching methods. HCRU and costs were assessed in each of the four quarters (Q4: 12-10 months; Q3: 9-7 months; Q2: 6-4 months; and Q1: 3-0 months) prior to death and compared between patient cohorts using paired t-tests and McNemar's tests.

Results: A final matched cohort of 7648 patients who died and 7648 patients who did not die were identified. A significantly higher proportion of patients who died utilized inpatient services vs. those who did not die (Q4: 12.6% vs. 4.6%, p < .001; Q3: 14.6% vs. 4.6%, p < .001; Q2: 17.6% vs. 5.5%, p < .001; and Q1: 65.0% vs. 10.1%, p < .001). In addition, patients who died incurred significantly higher all-cause costs (Q4: $8882 vs. $3970, p < .001; Q3: $10,462 vs. $3661, p < .001; Q2: $12,564 vs. $4169, p < .001; and Q1: $36,076 vs. $6319, p < .001).

Conclusions: T2DM patients with a CVD-related death had significantly greater HCRU and costs in the year including and preceding death compared to those who did not die.

Keywords: Diabetes mellitus; cardiovascular disease; cost analysis; death; healthcare utilization; type 2.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cardiovascular Diseases* / economics
  • Cardiovascular Diseases* / mortality
  • Cause of Death
  • Cohort Studies
  • Costs and Cost Analysis* / methods
  • Costs and Cost Analysis* / statistics & numerical data
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Health Care Rationing / methods
  • Health Care Rationing / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Retrospective Studies
  • United States / epidemiology