Cost of managing complications resulting from type 2 diabetes mellitus in CanadaReport as inadecuate

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BMC Health Services Research

, 3:7

First Online: 21 March 2003Received: 21 November 2002Accepted: 21 March 2003DOI: 10.1186-1472-6963-3-7

Cite this article as: O-Brien, J.A., Patrick, A.R. & Caro, J.J. BMC Health Serv Res 2003 3: 7. doi:10.1186-1472-6963-3-7


BackgroundDecision makers need to have Canadian-specific cost information in order to develop an accurate picture of diabetes management. The objective of this study is to estimate direct medical costs of managing complications of diabetes. Complication costs were estimated by applying unit costs to typical resource use profiles. For each complication, the event costs refer to those associated with the acute episode and subsequent care in the first year. State costs are the annual costs of continued management. Data were obtained from many Canadian sources, including the Ontario Case Cost Project, physician and laboratory fee schedules, formularies, reports, and literature. All costs are expressed in 2000 Canadian dollars.

ResultsMajor events e.g., acute myocardial infarction: $18,635 event cost; $1,193 state cost, generate a greater financial burden than early stage complications e.g., microalbuminuria: $62 event cost; $10 state cost. Yet, complications that are initially relatively low in cost e.g., microalbuminuria can progress to more costly advanced stages e.g., end-stage renal disease, $63,045 state cost.

ConclusionsMacrovascular and microvascular complication costs should be included in any economic analysis of diabetes. This paper provides Canadian-based cost information needed to inform critical decisions about spending limited health care dollars on emerging new therapies and public health initiatives.

AbbreviationsAÉTMISAgence d-évaluation des technologies et des modes d-intervention en santé

AKAabove the knee amputation

AMIacute myocardial infarction

CABGcoronary artery bypass graft

CMGscase mix groupings


ESRDend-stage renal disease

ICD-9International Classification of Diseases

LEAslower extremity amputations

LOSlength of stay

MEmacular edema

MImyocardia infarction

OCCPOntario Case Cost Project

PTCApercutaneous transluminal coronary angioplasty

TIAtransient ischemic attacks

USUnited States

US$United States dollars

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Author: Judith A O-Brien - Amanda R Patrick - J Jaime Caro


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