Healthcare costs associated with progressive diabetic retinopathy among National Health Insurance enrollees in Taiwan, 2000-2004Report as inadecuate




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BMC Health Services Research

, 10:136

First Online: 26 May 2010Received: 19 August 2009Accepted: 26 May 2010DOI: 10.1186-1472-6963-10-136

Cite this article as: Woung, LC., Tsai, CY., Chou, HK. et al. BMC Health Serv Res 2010 10: 136. doi:10.1186-1472-6963-10-136

Abstract

BackgroundDiabetic retinopathy is one of the most common microvascular complications of diabetes and one of the major causes of adult visual impairment in national surveys in Taiwan. This study aimed to identify the healthcare costs of Taiwan-s National Health Insurance program on behalf of diabetic patients with stable or progressive retinopathy.

MethodsA retrospective cohort study was conducted with 4,988 medication-using diabetic retinopathy subjects ≥ 40 years of age under National Health Insurance Program coverage between 2000 and 2004. Study cohort subjects were recorded as having diabetic retinopathy according to ICD-9-CM codes. States of diabetic retinopathy were strategically divided into stable and progressive categories according to subjects- conditions at follow-up in 2004. Expenditures were calculated and compared for the years 2000 and 2004.

ResultsDuring the 4-year follow-up 2000 through 2004, 4,116 subjects 82.5% of 4,988 diabetic subjects were in the stable category, and 872 17.5% were in the progressive category. Average costs of those in the normal category increased by US $48 from US $1921 in 2000 to US $1969 in 2004 p = 0.594, whereas costs for those progressing from normal to non-proliferative diabetic retinopathy NPDR or proliferative diabetic retinopathy PDR increased by US $1760, from US $1566 in 2000 to US $3326 in 2004 p < 0.001. The PDR category had the highest average costs at US $3632 in 2000. The NPDR-to-PDR category experienced the greatest increase in costs at US $3482, from US $2723 in 2000 to US $6204 in 2004 p = 0.042, and the greatest percentage of increase at 2.3% 2.2% when adjusted by comparing to normal category.

ConclusionsThis large-scale longitudinal study provides evidence that increased healthcare costs are associated with progressive diabetic retinopathy among diabetic NHI enrollees in Taiwan.

Ching-Yao Tsai, Hsin-Kai Chou contributed equally to this work.

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Author: Lin-Chung Woung - Ching-Yao Tsai - Hsin-Kai Chou - Ming-Tsu Tsai - Wei-Her Tsai - Pesus Chou - Shih-Tsuo Shen

Source: https://link.springer.com/







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