Cost of Medical Care of Type 2 Diabetes Mellitus Outpatients

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  • 2型糖尿病における外来医療費の研究
  • 2型糖尿病における外来医療費の研究--医療改革が糖尿病科に与える影響
  • 2ガタ トウニョウビョウ ニ オケル ガイライ イリョウヒ ノ ケンキュウ イリョウ カイカク ガ トウニョウビョウカ ニ アタエル エイキョウ
  • ―医療改革が糖尿病科に与える影響―
  • —Effect of Healthcare Reform on the Diabetes Clinic—

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Abstract

To verify the direct linear correlation between the cost of medical care and number of patient visits to the diabetes clinic per year, we analyzed the direct annual costs of medical care of type 2 diabetes mellitus (T 2 DM) outpatients and factors that affect them. The total annual medical cost and the cost per visit of patients with T 2 DM (n=161) in the diabetes clinic of Kyoto University hospital (2002), were : in the absence of complications, ¥130,473±104,147 (mean±SD) and ¥13,046±7,568 ; with one complication, ¥151,431±130,529 and ¥16,206±10,777 ; with two complications, ¥240,088±148,022 and ¥18,357±10,409 ; with three complications, ¥263,150±141,754 and ¥23,739±11,068 ; and with four complications, ¥355,343±177,080 and ¥30,822±16,148. Multiple regression analysis showed that the factor that most affected medical cost was insulin therapy. A single regression analysis showed that medical cost per visit was positively correlated with number of patient visits to the diabetes clinic per year. This indicated that patients who visited the hospital frequently tended to cost more per visit. There were also major differences between the medical costs of individuals with the same type of treatment or the same number visits per year, indicating that each case of T 2 DM requires individual treatment. Thus, our results suggest that by adhering to the health expenditure reduction policy and recommending less frequent visits to the diabetes clinic, there may a transient decrease in medical costs. However, that may also decrease treatment efficacy, which in turn may ultimately increase medical costs.

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