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What drives the rising cost of diabetes in urban China?

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In 44,994 urban Chinese patients, mean annual diabetes-related medical costs rose from $1,293 (2014) to $2,093 (2019); hospitalization multiplied cost 2.23× and cardiovascular/kidney complications added ~65%/54%.

Source

Trends in economic burden of type 2 diabetes in China: Based on longitudinal claim data

Liu X, Zhang L, Chen W · Frontiers in public health · 2023

doi.org/10.3389/fpubh.2023.1062903Read the full paper ↗24 citationscc by

Study at a glance

Design
Cohort — Longitudinal urban Chinese health-insurance claims 2014–2019 for people diagnosed with diabetes before January 2015; regression of DM cost on hospitalization and complications.
N
N=44994 · 44,994 patients (47% men; mean age 65.3); 89% UEBMI.
Population
Urban patients with diabetes in one eastern Chinese city, identified from the official health-management system.
Outcome
Annual diabetes-related direct medical cost (DM cost) and effects of hospitalization and six complication groups.

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

Pulled 2014–2019 claims for everyone diagnosed with diabetes before 2015 in one eastern city, classified six ICD-10 complication groups, described stratified DM costs, and used clustered multiple linear regression (exponentiated β as cost multipliers).

What they found

Complications prevalence rose from 58.9% (2014) to 91.9% (2019). Cost AAGR was 10.12%. Hospitalized patients’ 2019 mean cost was $4,524 vs $1,172 without admission. Cost scaled with complication count (1.83× to 7.53× vs none). Cardiovascular (+65%) and nephropathy (+54%) were the priciest types.

The limits

What it doesn't show

One city and insurance claims miss informal care and undiagnosed diabetes; observational multipliers are not causal proof that preventing one complication saves exactly 54–65%; coding intensity may rise over time.

Key terms

DM cost
Diabetes-related direct medical cost from claims, including complication-related care.
UEBMI / URRBMI
Urban employee vs urban-rural resident basic medical insurance schemes covering this cohort.
Hospitalization multiplier
Average annual DM cost 2.23 times higher with vs without inpatient care.
Complication count
Number of six ICD-10 complication groups; more groups meant steeply higher cost.
AAGR
Average annual growth rate of mean DM cost (10.12% here).

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Analytic n was about:

Common questions

How many patients?

44,994 people with diabetes.

Cost change 2014–2019?

From 1,292.72 to 2,092.87 USD per year on average.

Hospitalization effect?

2.23 times the DM cost of non-hospitalized patients.

Costliest complications?

Cardiovascular (+65%) and nephropathy (+54%).

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