Direct medical costs of diabetes mellitus in the year of mortality and year before mortality

Abstract

Aims: Studies have shown that health service utilization often increases in few years immediately before death. Estimates of direct medical cost of diabetes mellitus (DM) in mortality year and the previous year is not well understood. This study aimed to report the health resource use and estimate the direct medical costs among DM patients in the year of mortality and the year before mortality. Materials and Methods: We analysed a population-based, retrospective cohort study including all adults with DM diagnosis in Hong Kong between 2009 and 2013, and death between January 1, 2010 and December 31, 2013. Annual direct medical costs in year of mortality and year before mortality were determined by summing costs of health services utilized within the respective year. The costs were analysed by gender, the presence of co-morbidities, diabetic complications and primary cause of death. Results: A total of 10,649 patients met the eligibility criteria for analysis. On average, the direct medical costs in the year of death were 1.947 times higher than those in the year before death. Male and female patients had similar costs in the year before mortality and mortality year. Patients with any diabetic complications had greater costs in the year of mortality and before mortality than those without. Conclusions: This analysis provides new evidence on incorporating additional direct medical costs in the mortality year, and refining the structure of total cost estimates for use in costing and cost-effectiveness analyses of interventions for DM.