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Title: Assessment of medical and economic consequences of diabetes type 1 and 2 in Poland

Abstract:

The objective of a dissertation was an assessment of direct and indirect costs referring to diabetes type 1 and 2 in population of Cracow in 2004; economic burden of the disease has been assessed and influence of direct and indirect medical costs on total diabetes burden in Poland has been defined. To assess the burden of diabetes in population of Cracow direct medical costs of diagnosis and treatment were calculated based on medical resources consumption reported in Department of Endocrinology of Jagiellonian University Collegium Medicum and Chart of Internal Medicine of Railway Regional Hospital in Cracow in years: 2001-2003. A special questionnaire was used to assess medical resources consumption due to diabetes treatment mainly based on data on insulin and oral hypoglycemic drugs consumption during hospitalization and 12 months afterwards. Retrospective data was collected about therapy regimes in case of 381 patients treated in the above mentioned clinical centers. An annual costs of hospitalizations and ambulatory treatment of standard patient were taken into account; standard medium cost of in-patient therapy as well as number of re-hospitalizations in 12 months period and a number of ambulatory visits in case of out-patient treatment was calculated based on registers in both medical centers. Average annual costs of a standard patient treatment with diabetes type 1 were: 2 486.13 pln and in case of diabetes type 2: 2 294 pln. The structure of direct medical costs was as following: insulinotherapy consists about 50% of total direct medical costs of diabetes therapy and further 25% was generated by hospitalizations. Costs of diagnosis are really high (14%) because of use of diagnostic strips, what has been proved both by retrospective (patient history files) and prospective data (questionnaires collected in 5 ambulatories in Cracow). Oral hypoglycemic drugs generated about 11% of total diabetes treatment costs and out-patient visits due to diabetes 1 or 2 treatment were much less cost-consuming compared to above mentioned categories. Burden of illness was calculated for population of Cracow and total number of diabetic patients in the city was estimated on epidemiology data (4 000 patients with diabetes type 1 and 43 276 patients with diabetes type 2). Direct medical costs in case of the analyzed population were: 9 924 520 zł (4 000*2 481.13 zł) for diabetes type 1 and 99 275 144 (43 276*2 294 zł) for patients with diabetes type 2. Indirect costs reflected to productivity loss due to diabetes and its complications were also assessed in the analysis; sick leave in case of working population, costs of disability pensions and premature deaths were taken into consideration. Relevant data has been collected in 5 ambulatory settings in Cracow with questionnaires filled by patients in assistance of nurses; 385 questionnaires were collected in 3 months period. Based on results of the study annual indirect costs for a standard patient were assessed as 4 951 zł and the most eminent component of the costs were due to disability pensions (3 682.2 zł; 74% of total indirect costs). Taken into account the whole Cracow diabetic population it was calculated that total annual indirect costs due to diabetes were: 234 101 000 zł. Direct non-medical costs were also calculated in the analysis; costs of patients transportation and necessary help in case of disability were taken into consideration. Average costs of transportation were based on data reported in case files in Department of Endocrinology (Collegium Medicum UJ) and Regional Railway Hospital and disability costs were based on prospective questionnaire study (data from 5 out-patient therapy settings). Annual direct non-medical costs per patient were: 659.92 zł; so in case of whole diabetic population of Cracow: 31 198 377 zł. Results of the analysis specify that costs of diabetic complications are pretty high; average annual costs per patient were: 3 501. ; 67 zł so in case of whole analyzed population total annual costs were: 165 544 495 zł. Nephropathy, diabetic foot and Peripheral Arterial Occlusive Disease were the most costly diabetes complications; they generated: 28.5%, 18.1% and 12.7% of total diabetes complications costs, respectively. When all costs categories were taken into account it occurred that the most cost-consuming were direct medical costs, which generated 51% of total diabetes costs in analyzed population and 43% are indirect costs and direct non-medical costs composed 6%. Annual direct medical costs in analyzed population were: 274 678 112 zł and indirect costs: 234 101 296 zł, so in total it was: 540 067 000 zł and per one patient: 11 424 zł. A lot of patients in Poland live unaware of their illness (in case of diabetes type 2 the number of patients with undiagnosed disease is estimated as: 975 000 patients in Polish population) what is potentially harmful because of risk of onset of diabetes complications and damage of body organs and as consequence - necessity of high coverage on treatment in future. Preventive action (screening testing, early treatment) focused on unaware diabetics could be a solution reducing the risk of diabetic complications and improving therapy results in future.

Level of degree:

2 - studia doktoranckie

Degree discipline:

endokrynologia

Degree grantor:

Wydział Lekarski

Promoter:

Andrzej Pilc

Date issued:

2007

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:1146

Call number:

ZB-105914

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Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

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Last modified:

Feb 12, 2020

In our library since:

Nov 21, 2012

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http://dl.cm-uj.krakow.pl:8080/publication/1146

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ZB-105914 Feb 12, 2020
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