Abstract
Objective: We developed a measure of the cost of diabetes for general and North American Indian populations of Manitoba and estimated the excess costs of diabetes which are attributable to diabetes prevalence rates and per person utilization of health services.
Research Design and Methods: We obtained data from the Manitoba Medicare database and the Manitoba Diabetes Database. We estimated costs for each service and cost per person for four populations: Indian and general population groups with and without diabetes. Excess cost formulas were estimated.
Results: Prevalence and utilization were considerably higher for the North American Indian population. As a first approximation, excess costs due to disease prevalence added 15.9% to total costs, while excess costs due to utilization add 14.6%.
Conclusions: Disease prevalence indicates a need to focus on primary preventive measures. High utilization indicates complications, and suggests a need for secondary prevention.
Résumé
Objectif: Nous avons effectué une évaluation des coûts du diabète pour l’ensemble de la population et pour la population amérindienne du Manitoba et avons évalué le coût supplémentaire que l’on peut attribuer au taux de prévalence du diabète et à l’utilisation des services de santé en fonction du nombre de personnes.
Conception et méthodes de recherche: Nous avons obtenu des données des bases de données Manitoba Medicare et Manitoba Diabetes. Nous avons évalué les coûts de chaque service ainsi que les coûts par personne pour quatre groupes de la population: la population autochtone et l’ensemble de la population faisant ou non du diabète. Des évaluations des formules relatives aux coûts supplémentaires ont été effectuées.
Résultats: Les taux de prévalence et d’utilisation étaient beaucoup plus élevés chez les amérindiens. Selon une première approximation, les coûts supplémentaires engendrés par la prévalence de la maladie représentaient 15,9 % des coûts totaux, alors que les coûts supplémentaires engendrés par l’utilisation des services représentaient 14,6 %.
Conclusions: La prévalence de la maladie démontre qu’il faut mettre l’accent sur les mesures primaires de prévention. Les taux élevés d’utilisation démontrent qu’il y a eu des complications et qu’il faudrait prendre des mesures secondaires de prévention.
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References
Moore R, Mao Y, Zhang J, et al. Economic Burden of Illness in Canada, 1993. Ottawa: Canadian Public Health Association. 1997; H21-136/1993E.
Leese B. The costs of diabetes and its complications. Soc Sci Med 1992;35:1303–10.
Gerard K, Donaldson C, Maynard AK. The cost of diabetes. Diabetic Medicine 1989;6:164–70.
Rubin RJ, Altman WM, Mendelson DN. Health care expenditures for people with diabetes mellitus, 1992. J Clin Endocrinol Metab 1994;78(4):809A–F.
Huse DM, Oster G, Killen AR, et al. The economic costs of non-insulin-dependent diabetes mellitus. JAMA 1989;262(19):2708–13.
Songer TJ, Alberti KGMM, DeFronzo RA, et al. (Eds.) The economics of diabetes care. In: International Textbook of Diabetes Mellitus. Chichester: John Wiley and Sons, 1992;73:1643–54.
McKendry JBR. Direct costs of diabetes care: A survey in Ottawa, Ontario 1986. Can J Public Health 1989;80:124–28.
Selby JV, Ray GT, Zhang D, Colby CJ. Excess costs of medical care for patients with diabetes in a managed care population. Diabetes Care 1997;20(9):1396.
Young TK. Diabetes in the Aboriginal Population of Canada: A Strategy Paper. Winnipeg, Manitoba. Department of Community Health Sciences, University of Manitoba. 1997.
Bobet E. Diabetes among First Nations People: Information from the 1991 Aboriginal Peoples Survey carried out by Statistics Canada. Statistics Canada, 1997;1–39.
Roos LL, Roos NP, Cageorge SM, Nicol P. How good are the data: Reliability of one health care data bank. Medical Care 1982;20(266):276.
Roos L, Mustard CA, Nicol P. Registries and administrative data: Organization and accuracy. Medical Care 1998;31:201–12.
Blanchard JF, Ludwig S, Wajda A, et al. Incidence and prevalence of diabetes in Manitoba, 1986–1991. Diabetes Care 1996;19(8):807–11.
Canadian Institute for Health Information. Resource intensity weights: Summary of methodology 1996/97. Ottawa: Canadian Institute for Health Information, 1996.
Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977–86.
Diabetes Control and Complications Trial Research Group. Resource utilization and costs of care in the diabetes control and complications trial. Diabetes Care 1995;18:1468–78.
Diabetes Control and Complications Trial Research Group. Lifetime benefits and costs of intensive therapy as practiced in the diabetes control and complications trial. JAMA 1996;276:1409–15.
Turner RC. Prospective diabetes study: A review. Diabetes Care 1998;21(Supplement 3):C35–C38.
UK Prospective Diabetes Study Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes. Lancet 1998;352:854–65.
UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes. BMJ 1998;317:703–13.
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Jacobs, P., Blanchard, J.F., James, R.C. et al. Excess Costs of Diabetes in the Aboriginal Population of Manitoba, Canada. Can J Public Health 91, 298–301 (2000). https://doi.org/10.1007/BF03404293
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DOI: https://doi.org/10.1007/BF03404293