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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #270395
Title: Predictors of direct cost of diabetes care in pediatric patients with type 1 diabetes

Author
item YING, ANITA - Md Anderson Cancer Center
item LAIRSON, DAVID - University Of Texas Health Science Center
item GIARDINO, ANGELO - Baylor College Of Medicine
item BONDY, MELISSA - Md Anderson Cancer Center
item ZAHEER, IRUM - Methodist Hospital
item Haymond, Morey - Children'S Nutrition Research Center (CNRC)
item HEPTULLA, RUBINA - Baylor College Of Medicine

Submitted to: Pediatric Diabetes
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/20/2010
Publication Date: 4/26/2011
Citation: Ying, A.K., Lairson, D.R., Giardino, A.P., Bondy, M.L., Zaheer, I., Haymond, M.W., Heptulla, R.A. 2011. Predictors of direct cost of diabetes care in pediatric patients with type 1 diabetes. Pediatric Diabetes. 12:177-182.

Interpretive Summary: This study examines factors that predict the direct costs of pediatric patients with type 1 diabetes. We examined utilization of care, total diabetes-related direct medical costs, and predictors of direct costs and hospitalization. Annually, 7% (58/784)of patients (excluding initial hospitalization at diagnosis) had a diabetes-related hospitalization. Mean total diabetes-related direct cost per person-year was $4730 [95% confidence interval 4516–4944]. Supplies accounted for 38% and medications 33% of costs, respectively. Better metabolic control in patients with type 1 diabetes was associated with lower direct medical costs and lower odds of hospitalization. Marital status of the primary caregiver, irrespective of type of insurance, impacts the patient's healthcare costs and risk of hospitalization. This large single-center US study analyzes cost distribution in children with diabetes and is informative for payers and providers focused on effective management and improving healthcare costs.

Technical Abstract: This study examines factors that predict elevated direct costs of pediatric patients with type 1 diabetes. Methods: A cohort of 784 children with type 1 diabetes at least 6 months postdiagnosis and managed by pediatric endocrinologists at Texas Children's Hospital were included in this study. Actual reimbursed costs from January 2004 to December 2005 were obtained. Medication and supply costs were based on estimates from insulin dosage and type of insulin regimen prescribed, respectively. We examined utilization of care, total diabetes-related direct medical costs, and predictors of direct costs and hospitalization. Annually, 7% (58/784) of patients (excluding initial hospitalization at diagnosis) had a diabetes-related hospitalization and median length of stay was days. Mean total diabetes-related direct cost per person-year was $4730 [95% confidence interval (CI), 4516–4944]. Supplies accounted for 38% and medications 33% of costs, respectively. Older age, hemoglobin A1C (HbA1C) > 8.5%, use of a multi-injection or pump regimen, living in a non-married household, and female gender were associated with higher annual costs. HbA1C > 8.5%, living in a non-married household, and female gender increased the odds of a diabetes-related hospitalization. Better metabolic control in patients with type 1 diabetes was associated with lower direct medical costs and lower odds of hospitalization. Marital status of the primary caregiver, irrespective of type of insurance, impacts the patient's healthcare costs and risk of hospitalization. This large single-center US study analyzes cost distribution in children with diabetes and is informative for payers and providers focused on effective management and improving healthcare costs.