International Diabetes Management Practices Study (IDMPS). Resources consumption: direct medical and indirect costs

GAGLIARDINO JJ

Montreal, Canadá

Congreso; IDF 20th World Diabetes Congress; 2009

International Diabetes Federation

Aims: To estimate resource consumption by people with type 2 diabetes (T2DM) in 24 countries. Methods: Cross-sectional observational record of resource use in 15,016 people with T2DM (Asia 4678, Latin America [LA] 6090 and Middle East & Africa [ME&A] 4248), within the second wave of IDMPS. Annual quantities (mean ± SD) were measured and predictors of diabetes-related hospitalisations and absenteeism were determined using negative binomial regression. Results: Patient doctor visits: 3.4 ± 6.9, 5.4 ± 6.7 and 2.5 ± 4.4 times/year in Asia, LA and ME&A, respectively. Percentage of hospitalization: 8.5%, 6.5% and 8.8%; average stay: 3.8 ± 18.1, 2.2 ± 13.9 and 2.6 ± 13.5 days/year, respectively (total of 42.000 days/year). Mean days of absenteeism: 5.0 ± 23.1, 6.4 ± 33.2 and 5.7 ± 24.3 in the regions (total of 86.000 days lost/year). The regression analysis showed that chronic complications and inadequate glycaemic control (HbA1c > 7.0%) were the major predictors of resource use. The annual hospitalisation rate was significantly greater in patients with than without macrovascular complications in Asia (incidence rate ratio (IRR) 4.7, 95%  CI 2.8-7.8, n2551), 5.4 times greater in LA (IRR 5.4, 95% CI 3.0-9.8, n 3228) and 4.4 times greater in ME&A (IRR 4.4, 95% CI 2.8-6.9, n2630). Conclusions: In developing countries, micro- and macrovascular complications and inadequate glycaemic control are significant predictors of resource use in T2DM. These results confirm the importance of appropriate diabetes control to prevent the development/progression of chronic complications and the consequent increase in the cost of care.