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Diabetes costs utilization

Daria J O'Reilly, Natasha Burke, Jean-Eric Tarride, Jina Hahn, Larisa Nurkanovic
OBJECTIVES: There is a paucity of information concerning the cost of hypoglycemia events in Canadians with type 1 or type 2 diabetes. The objective of this study was to estimate the direct health-care costs and indirect costs associated with hypoglycemia based on a Canadian cohort of 498 patients from the global Hypoglycemia Assessment Tool (HAT) study. METHODS: A costing model was developed to estimate the direct costs related to experiencing hypoglycemia by using health-care resources associated with hospital admissions and additional clinical appointments that were prospectively reported 1 month after baseline in the HAT study...
January 31, 2018: Canadian Journal of Diabetes
Hae Sun Suh, Jee-Ae Kim, Iyn-Hyang Lee
BACKGROUND: Despite the potential widespread application and a significant need, the policy effectiveness of prescribed medications price controls has not been studied extensively. We aimed to explore the effects of a price cut introduced in April 1st of 2012 on the cost and utilization of antidiabetics in South Korea. METHODS: We identified approximately four million outpatients who filed at least one diabetes-related claim during the index period (January 2010 to December 2012) using the National Health Insurance claims data...
June 8, 2018: BMC Health Services Research
Stephen L Thorp, Thomas Suchy, Nalini Vadivelu, Erik M Helander, Richard D Urman, Alan D Kaye
BACKGROUND: Chronic pain is a major public health problem resulting in physical and emotional pain for individuals and families, loss of productivity, and an annual cost of billions of dollars. The lack of objective measures available to aid in diagnosis and evaluation of therapies for chronic pain continues to be a challenge for the clinician. OBJECTIVES: Functional magnetic resonance imaging (fMRI) is an imaging technique that can establish regional areas of interest and examine synchronous neuronal activity in functionally related but anatomically distinct regions of the brain, known as functional connectivity...
May 2018: Pain Physician
Yanting Guo, Gang Zheng, Tianyun Fu, Shiying Hao, Chengyin Ye, Le Zheng, Modi Liu, Minjie Xia, Bo Jin, Chunqing Zhu, Oliver Wang, Qian Wu, Devore S Culver, Shaun T Alfreds, Frank Stearns, Laura Kanov, Ajay Bhatia, Karl G Sylvester, Eric Widen, Doff B McElhinney, Xuefeng Bruce Ling
BACKGROUND: For many elderly patients, a disproportionate amount of health care resources and expenditures is spent during the last year of life, despite the discomfort and reduced quality of life associated with many aggressive medical approaches. However, few prognostic tools have focused on predicting all-cause 1-year mortality among elderly patients at a statewide level, an issue that has implications for improving quality of life while distributing scarce resources fairly. OBJECTIVE: Using data from a statewide elderly population (aged ≥65 years), we sought to prospectively validate an algorithm to identify patients at risk for dying in the next year for the purpose of minimizing decision uncertainty, improving quality of life, and reducing futile treatment...
June 4, 2018: Journal of Medical Internet Research
Zsolt Hepp, Maureen J Lage, Ramon Espaillat, Ved V Gossain
OBJECTIVE: To evaluate outcomes associated with adherence to levothyroxine (LT4) in the US adult hypothyroidism population. METHODS: We used data from Truven's MarketScan databases from July 1, 2011 through December 31, 2015. Patients aged 18 or older were diagnosed with hypothyroidism (confirmed at least twice) and prescribed LT4. Patients were excluded if they did not have continuous insurance coverage or if they received a diagnosis of thyroid cancer or pregnancy during the study period...
June 5, 2018: Journal of Medical Economics
Ira L Leeds, Joseph K Canner, Faiz Gani, Patrick M Meyers, Elliott R Haut, Jonathan E Efron, Fabian M Johnston
OBJECTIVE: The purpose of this study was to evaluate the impact of optimization of preoperative comorbidities by nonsurgical clinicians on short-term postoperative outcomes. SUMMARY BACKGROUND DATA: Preoperative comorbidities can have substantial effects on operative risk and outcomes. The modifiability of these comorbidity-associated surgical risks remains poorly understood. METHODS: We identified patients with a major comorbidity (eg, diabetes, heart failure) undergoing an elective colectomy in a multipayer national administrative database (2010-2014)...
June 1, 2018: Annals of Surgery
Beau J Kildow, Vasili Karas, Elizabeth P Howell, Cynthia L Green, William T Baumgartner, Colin T Penrose, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Routine laboratory studies are often obtained daily after total joint arthroplasty (TJA) regardless of medical management. The purpose of this study was to investigate the utility of routine basic metabolic panel (BMP) tests after TJA. Furthermore, the goal was to identify factors that may predispose patients to abnormal laboratory values that require medical intervention. METHODS: A retrospective review was performed on 767 patients who underwent primary TJA at a single institution...
May 9, 2018: Journal of Arthroplasty
Max Gill, Harmeet Chhabra, Mona Shah, Cyrus Zhu, George Grunberger
OBJECTIVE: To study the impact of the C-peptide and β-cell autoantibody testing required by the Center for Medicare and Medicaid Services (CMS) on costs/utilization for patients with diabetes mellitus (DM) initiating continuous subcutaneous insulin infusion (CSII) therapy. METHODS: This retrospective study used propensity score-matched patients. Analysis 1 compared patients 1-year pre- and 2-year post-CSII adoption who met or did not meet CMS criteria. Analysis 2 compared Medicare Advantage patients using CSII or multiple daily injections (MDI), who did not meet CMS criteria, for 1-year pre- and 1-year post-CSII adoption...
May 31, 2018: Endocrine Practice
Richard F Pollock, Barrie Chubb, William J Valentine, Simon Heller
Background: To estimate the short-term cost-effectiveness of insulin detemir (IDet) versus neutral protamine Hagedorn (NPH) insulin based on the incidence of non-severe hypoglycemia and changes in body weight in subjects with type 1 diabetes (T1D) or type 2 diabetes (T2D) in the UK. Methods: A model was developed to evaluate cost-effectiveness based on non-severe hypoglycemia, body mass index, and pharmacy costs over 1 year. Published rates of non-severe hypoglycemia were employed in the T1D and T2D analyses, while reduced weight gain with IDet was modeled in the T2D analysis only...
2018: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Chris Kypridemos, Brendan Collins, Philip McHale, Helen Bromley, Paula Parvulescu, Simon Capewell, Martin O'Flaherty
BACKGROUND: Aiming to contribute to prevention of cardiovascular disease (CVD), the National Health Service (NHS) Health Check programme has been implemented across England since 2009. The programme involves cardiovascular risk stratification-at 5-year intervals-of all adults between the ages of 40 and 74 years, excluding any with preexisting vascular conditions (including CVD, diabetes mellitus, and hypertension, among others), and offers treatment to those at high risk. However, the cost-effectiveness and equity of population CVD screening is contested...
May 2018: PLoS Medicine
Jun Yang Lee, Shaun Wen Huey Lee
BACKGROUND: Telemedicine has been utilized increasingly worldwide for diabetes management, due to its potential to improve healthcare access and clinical outcomes. Few studies have assessed the economic benefits of telemedicine, which may contribute to underfunding in potentially important programs. We aim to systematically review the literature on economic evaluations of telemedicine in diabetes care, assess the quality, and summarize the evidence on driver of cost-effectiveness. MATERIALS AND METHODS: A literature search was performed in 10 databases from inception until February 2018...
May 29, 2018: Diabetes Technology & Therapeutics
Gretchen A Piatt, Elizabeth A Rodgers, Lingshu Xue, Janice C Zgibor
Purpose The purpose of the study was to evaluate the effectiveness of a peer leader-led (PL) diabetes self-management support (DSMS) group in achieving and maintaining improvements in A1C, self-monitoring of blood glucose (SMBG), and diabetes distress in individuals with diabetes. Diabetes self-management support is critical; however, effective, sustainable support models are scarce. Methods The study was a cluster randomized controlled trial of 221 people with diabetes from 6 primary care practices. Practices and eligible participants (mean age: 63...
May 1, 2018: Diabetes Educator
R S Drummond, Sjp Malkin, M Du Preez, X Y Lee, B Hunt
AIMS: Insulin degludec/liraglutide (IDegLira) is a once-daily, single-injection, fixed-ratio combination of insulin degludec, a basal insulin with a half-life of more than 24 hours, and GLP-1 receptor agonist liraglutide. The present analysis evaluated the cost-effectiveness of IDegLira versus basal-bolus therapy (BBT) with insulin glargine U100 plus up to four times daily insulin aspart for management of type 2 diabetes in the UK. MATERIALS AND METHODS: A Microsoft Excel model was used to evaluate the cost-utility of IDegLira versus BBT over a 1-year time horizon...
May 24, 2018: Diabetes, Obesity & Metabolism
Gary R Matzke, Leticia R Moczygemba, Karen J Williams, Michael J Czar, William T Lee
PURPOSE: The impact of a pharmacist-physician collaborative care model on patient outcomes and health services utilization is described. METHODS: Six hospitals from the Carilion Clinic health system in southwest Virginia, along with 22 patient-centered medical home (PCMH) practices affiliated with Carilion Clinic, participated in this project. Eligibility criteria included documented diagnosis of 2 or more of the 7 targeted chronic conditions (congestive heart failure, hypertension, hyperlipidemia, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and depression), prescriptions for 4 or more medications, and having a primary care physician in the Carilion Clinic health system...
May 22, 2018: American Journal of Health-system Pharmacy: AJHP
Ignacio Conget, Pilar Martín-Vaquero, Stéphane Roze, Isabel Elías, Cristina Pineda, María Álvarez, Alexis Delbaere, Francisco Javier Ampudia-Blasco
OBJECTIVE: To compare the cost-effectiveness of sensor-augmented pump therapy (SAP) [continuous subcutaneous insulin infusion (CSII) plus real-time continuous glucose monitoring (RT-CGM)] with low glucose suspend (MiniMed™ Veo™) and CSII alone in patients with type 1 diabetes mellitus (T1DM) at high risk of hypoglycemia in Spain. METHODS: The IQVIA CORE Diabetes Model was used to estimate healthcare outcomes as life-years gained (LYGs) and quality-adjusted life years (QALYs), and to project lifetime costs...
May 19, 2018: Endocrinología, Diabetes y Nutrición
Martina Vettoretti, Giacomo Cappon, Giada Acciaroli, Andrea Facchinetti, Giovanni Sparacino
The recent announcement of the production of new low-cost continuous glucose monitoring (CGM) sensors, the approval of marketed CGM sensors for making treatment decisions, and new reimbursement criteria have the potential to revolutionize CGM use. After briefly summarizing current CGM applications, we discuss how, in our opinion, these changes are expected to extend CGM utilization beyond diabetes patients, for example, to subjects with prediabetes or even healthy individuals. We also elaborate on how the integration of CGM data with other relevant information, for example, health records and other medical device/wearable sensor data, will contribute to creating a digital data ecosystem that will improve our understanding of the etiology and complications of diabetes and will facilitate the development of data analytics for personalized diabetes management and prevention...
May 1, 2018: Journal of Diabetes Science and Technology
Aapeli Leminen, Markku Tykkyläinen, Tiina Laatikainen
BACKGROUND: Type 2 diabetes (T2DM) is a major health concern in most regions. In addition to direct healthcare costs, diabetes causes many indirect costs that are often ignored in economic analyses. Patients' travel and time costs associated with the follow-up of T2DM patients have not been previously calculated systematically over an entire healthcare district. The aim of the study was to develop a georeferenced cost model that could be used to measure healthcare accessibility and patient travel and time costs in a sparsely populated healthcare district in Finland...
July 2018: International Journal of Medical Informatics
Dimpi Desai, Dhruv Mehta, Priyanka Mathias, Gopal Menon, Ulrich K Schubart
OBJECTIVE: Diabetes is one of the most common chronic diseases and a leading cause of morbidity and mortality in the U.S. Although our ability to treat diabetes and its associated complications has significantly improved, presentation with uncontrolled diabetes leading to ketoacidosis remains a significant problem. RESEARCH DESIGN AND METHODS: We aimed to determine the incidence and costs of hospital admissions associated with diabetic ketoacidosis (DKA). We reviewed the National Inpatient Sample Database for all hospitalizations in which DKA (ICD-9 codes 250...
May 17, 2018: Diabetes Care
Ilya Golovaty, Monisha Sharma, Alastair Van Heerden, Heidi van Rooyen, Jared M Baeten, Connie Celum, Ruanne V Barnabas
INTRODUCTION: Integrated HIV-non-communicable disease (NCD) services have the potential to avert death and disability, but require data on program costs to assess the impact of integrated services on affordability. METHODS: We estimated the incremental costs of NCD screening as part of home-based HIV testing and counseling (HTC) and referral to care in KwaZulu-Natal, South Africa. All adults in the households were offered integrated HIV-NCD screening (for HIV, diabetes, hypertension, hypercholesterolemia, obesity, depression, tobacco and alcohol use), counseling, and linkage to care...
May 10, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
David D Kim, David E Arterburn, Sean D Sullivan, Anirban Basu
OBJECTIVE: Designing optimal insurance is important to ensure access to care for individuals that are most likely to benefit. We examined the potential impact of lowering patient cost-sharing for bariatric procedures. METHODS: After defining 10 subgroups by body mass index (BMI) and type 2 diabetes mellitus (T2DM), we analyzed the National Health and Nutrition Examination Survey datasets to estimate the prevalence of each subgroup. The MarketScan claims database provided utilization rates and costs of bariatric procedures...
May 12, 2018: Medical Care
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