Estimating the Economic Burden of Type 2 Diabetes Among the Elderly in Tehran Province
-
Salar Ghorbani
,
Aziz Rezapour
,
Reza Jahangiri
,
Saeed Bagheri Bagheri Faradonbeh
,
Niloofar Ghotbiyan
,
Elham Saeedian
Abstract
Background: The prevalence of non-communicable diseases such as diabetes tends to rise with age, peaking among the elderly population. Objectives: This study aimed to estimate the economic burden of type 2 diabetes mellitus (T2DM) among the elderly in Tehran province.
Methods: This research employs a descriptive-analytical approach, focusing on T2DM patients who attended the specialized diabetes clinic of Tehran province in 2019. A total of 1256 cases were included in the study. Data collection involved reviewing hospital records and accessing information from the accounting department. Data analysis was conducted using Excel software.
Results: The economic burden of T2DM amounted to 432,471,301,510 Rials. Among this, 230,841,323,930 Rials (53.3%) were attributed to the costs of diagnosis and treatment, while 180,365,897,580 Rials (41.7%) were associated with treating disease complications. Additionally, 9,043,200,000 Rials (2%) accounted for non-medical direct costs (NMDC), and 12,220,880 Rials (0.3%) were attributed to NMDC due to complications.
Conclusions: Given the substantial financial burden incurred by elderly T2DM patients and the constraints on healthcare resources, it is imperative to prioritize preventive and therapeutic measures for this demographic. Comprehensive efforts are needed to mitigate the costs and consequences of this disease within the healthcare system.
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9. Taheri Tanjani P, Moradinazar M, Esmail Mottlagh M, Najafi F. The prevalence of diabetes mellitus (DM) type II among Iranian elderly population and its association with other age-related diseases, 2012. Arch Gerontol Geriatr. 2015;60(3):373-9. [PubMed ID:25623857]. https://doi.org/10.1016/j.archger.2014.11.012.
10. Williams R, Karuranga S, Malanda B, Saeedi P, Basit A, Besancon S, et al. Global and regional estimates and projections of diabetes-related health expenditure: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2020;162:108072. [PubMed ID:32061820]. https://doi.org/10.1016/j.diabres.2020.108072.
11. de Lagasnerie G, Aguade AS, Denis P, Fagot-Campagna A, Gastaldi-Menager C. The economic burden of diabetes to French national health insurance: a new cost-of-illness method based on a combined medicalized and incremental approach. Eur J Health Econ. 2018;19(2):189-201. [PubMed ID:28190188]. [PubMed Central ID:PMC5813074]. https://doi.org/10.1007/s10198-017-0873-y.
12. Eshwari K, Kamath VG, Rao CR, Kamath A. Economic burden of type 2 diabetes mellitus management: epidemiological determinants from a coastal community of southern India. WHO SouthEast Asia journal of public health. 2021;10(2):84-9.
13. Mata-Cases M, Casajuana M, Franch-Nadal J, Casellas A, Castell C, Vinagre I, et al. Direct medical costs attributable to type 2 diabetes mellitus: a population-based study in Catalonia, Spain. Eur J Health Econ. 2016;17(8):1001-10. [PubMed ID:26542160]. [PubMed Central ID:PMC5047944]. https://doi.org/10.1007/s10198-015-0742-5.
14. Acharya LD, Rau NR, Udupa N, Rajan MS, Vijayanarayana K. Assessment of cost of illness for diabetic patients in South Indian tertiary care hospital. J Pharm Bioallied Sci. 2016;8(4):314-20. [PubMed ID:28216956]. [PubMed Central ID:PMC5314831]. https://doi.org/10.4103/0975-7406.199336.
15. Amon SK, Aikins MKS. Economic burden of type 2 diabetes mellitus complications among patients in the eastern region of Ghana: A descriptive cross-sectional cost-of-illness study. Diabetes Management. 2017;7(5):367-76.
16. Huse DM, Oster G, Killen AR, Lacey MJ, Colditz GA. The economic costs of non-insulin-dependent diabetes mellitus.
JAMA. 1989;262(19):2708-13. [PubMed ID:2509743]. https://doi.org/10.1001/jama.262.19.2708.
17. O’Brien JA, Shomphe LA, Kavanagh PL, Raggio G, Caro JJ. Direct medical costs of complications resulting from type 2 diabetes in the U.S. Diabetes Care. 1998;21(7):1122-8. [PubMed ID:9653606]. https://doi.org/10.2337/diacare.21.7.1122.
18. Amini M. [Investigating the economic costs of diabetes in type 2 diabetic patients covered by Isfahan Endocrine and Metabolism Research Center in 1377]. Iran J Endocrine Metabolism. 1998;4(2).Persian.
19. Yeaw J, Halinan S, Hines D, Delozier A, Perez M, Boye M, et al. Direct medical costs for complications among children and adults with diabetes in the US commercial payer setting. Appl Health Econ Health Policy. 2014;12(2):219-30. [PubMed ID:24573912]. https://doi.org/10.1007/s40258-014-0086-9.
20. Caro JJ, Ward AJ, O’Brien JA. Lifetime costs of complications resulting from type 2 diabetes in the U.S. Diabetes Care. 2002;25(3):476-81. [PubMed ID:11874933]. https://doi.org/10.2337/diacare.25.3.476.
21. Hidayat B, Ramadani RV, Rudijanto A, Soewondo P, Suastika K, Siu Ng JY. Direct Medical Cost of Type 2 Diabetes Mellitus and Its Associated Complications in Indonesia. Value Health Reg Issues. 2022;28:82-9. [PubMed ID:34839111]. https://doi.org/10.1016/j.vhri.2021.04.006.
22. Javanbakht M, Baradaran HR, Mashayekhi A, Haghdoost AA, Khamseh ME, Kharazmi E, Sadeghi A. Cost-of-illness analysis of type 2 diabetes mellitus in Iran. PLoS One. 2011;6(10):e26864. [PubMed ID:22066013]. [PubMed Central ID:PMC3204988]. https://doi.org/10.1371/journal.pone.0026864.
23. Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH. Poverty and access to health care in developing countries. Ann N Y Acad Sci. 2008;1136:161-71. [PubMed ID:17954679]. https://doi.
org/10.1196/annals.1425.011.
24. American Diabetes A. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033-46. [PubMed ID:23468086]. [PubMed Central ID:PMC3609540]. https://doi.org/10.2337/dc12-2625.
25. Chatterjee S, Riewpaiboon A, Piyauthakit P, Riewpaiboon W, Boupaijit K, Panpuwong N, Archavanuntagul V. Cost of diabetes and its complications in Thailand: a complete picture of economic burden. Health Soc Care Community. 2011;19(3):289-98. [PubMed ID:21276105]. https://doi.org/10.1111/j.1365-2524.2010.00981.x.
26. American Diabetes A. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care. 2018;41(5):917-28. [PubMed ID:29567642]. [PubMed Central ID:PMC5911784]. https://doi.org/10.2337/dci18-0007.
27. Al-Maskari F, El-Sadig M, Nagelkerke N. Assessment of the direct medical costs of diabetes mellitus and its complications in the United Arab Emirates. BMC Public Health. 2010;10:679. [PubMed ID:21059202]. [PubMed Central ID:PMC2988742]. https://doi.org/10.1186/1471-2458-10-679.
28. Bayazidi Y, Davari M. The Estimation of the Imposed Economic Burden Due to Inadequate Medical Care in Patients Suffering from Type 2 Diabetes in Tehran. Social Security Journal. 2020;15(4):121-31.
2. Sadeghi MA, Kharazmi E, Javanbakht M, Heidari A, Bayati M. [Economics cost of diabetes in type II diabetic patients]. 2012. Persian. Available from: file:///C:/Users/Net/Downloads/54613910404.pdf.
3. Stout MB, Justice JN, Nicklas BJ, Kirkland JL. Physiological Aging: Links Among Adipose Tissue Dysfunction, Diabetes, and Frailty. Physiology (Bethesda). 2017;32(1):9-19. [PubMed ID:27927801].[PubMed Central ID:PMC5338596]. https://doi.org/10.1152/physiol.00012.2016.
4. Gomez-Huelgas R, Gomez Peralta F, Rodriguez Manas L, Formiga F, Puig Domingo M, Mediavilla Bravo JJ, et al. Treatment of type 2 diabetes mellitus in elderly patients. Rev Clin Esp (Barc). 2018;218(2):74-88. [PubMed ID:29366502]. https://doi.org/10.1016/j.rce.2017.12.003.
5. Shaw JE, Chisholm DJ. 1: Epidemiology and prevention of type 2 diabetes and the metabolic syndrome. Med J Aust.
2003;179(7):379-83. [PubMed ID:14503906]. https://doi.org/10.5694/j.1326-5377.2003.tb05677.x.
6. Chentli F, Azzoug S, Mahgoun S. Diabetes mellitus in elderly. Indian J Endocrinol Metab. 2015;19(6):744-52. [PubMed ID:26693423]. [PubMed Central ID:PMC4673801]. https://doi.org/10.4103/2230-8210.167553.
7. Kalra S, Kumar A, Jarhyan P, Unnikrishnan AG. Endemic or epidemic? Measuring the endemicity index of diabetes. Indian J Endocrinol Metab. 2015;19(1):5-7. [PubMed ID:25593819].[PubMed Central ID:PMC4287779]. https://doi.org/10.4103/2230-8210.144633.
8. Davari M, Boroumand Z, Amini M, Aslani A, Hosseini M. The Direct Medical Costs of Outpatient Cares of Type 2 Diabetes in Iran: A Retrospective Study. Int J Prev Med. 2016;7:72. [PubMed ID:27217937]. [PubMed Central ID:PMC4872475]. https://doi.org/10.4103/2008-7802.181758.
9. Taheri Tanjani P, Moradinazar M, Esmail Mottlagh M, Najafi F. The prevalence of diabetes mellitus (DM) type II among Iranian elderly population and its association with other age-related diseases, 2012. Arch Gerontol Geriatr. 2015;60(3):373-9. [PubMed ID:25623857]. https://doi.org/10.1016/j.archger.2014.11.012.
10. Williams R, Karuranga S, Malanda B, Saeedi P, Basit A, Besancon S, et al. Global and regional estimates and projections of diabetes-related health expenditure: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2020;162:108072. [PubMed ID:32061820]. https://doi.org/10.1016/j.diabres.2020.108072.
11. de Lagasnerie G, Aguade AS, Denis P, Fagot-Campagna A, Gastaldi-Menager C. The economic burden of diabetes to French national health insurance: a new cost-of-illness method based on a combined medicalized and incremental approach. Eur J Health Econ. 2018;19(2):189-201. [PubMed ID:28190188]. [PubMed Central ID:PMC5813074]. https://doi.org/10.1007/s10198-017-0873-y.
12. Eshwari K, Kamath VG, Rao CR, Kamath A. Economic burden of type 2 diabetes mellitus management: epidemiological determinants from a coastal community of southern India. WHO SouthEast Asia journal of public health. 2021;10(2):84-9.
13. Mata-Cases M, Casajuana M, Franch-Nadal J, Casellas A, Castell C, Vinagre I, et al. Direct medical costs attributable to type 2 diabetes mellitus: a population-based study in Catalonia, Spain. Eur J Health Econ. 2016;17(8):1001-10. [PubMed ID:26542160]. [PubMed Central ID:PMC5047944]. https://doi.org/10.1007/s10198-015-0742-5.
14. Acharya LD, Rau NR, Udupa N, Rajan MS, Vijayanarayana K. Assessment of cost of illness for diabetic patients in South Indian tertiary care hospital. J Pharm Bioallied Sci. 2016;8(4):314-20. [PubMed ID:28216956]. [PubMed Central ID:PMC5314831]. https://doi.org/10.4103/0975-7406.199336.
15. Amon SK, Aikins MKS. Economic burden of type 2 diabetes mellitus complications among patients in the eastern region of Ghana: A descriptive cross-sectional cost-of-illness study. Diabetes Management. 2017;7(5):367-76.
16. Huse DM, Oster G, Killen AR, Lacey MJ, Colditz GA. The economic costs of non-insulin-dependent diabetes mellitus.
JAMA. 1989;262(19):2708-13. [PubMed ID:2509743]. https://doi.org/10.1001/jama.262.19.2708.
17. O’Brien JA, Shomphe LA, Kavanagh PL, Raggio G, Caro JJ. Direct medical costs of complications resulting from type 2 diabetes in the U.S. Diabetes Care. 1998;21(7):1122-8. [PubMed ID:9653606]. https://doi.org/10.2337/diacare.21.7.1122.
18. Amini M. [Investigating the economic costs of diabetes in type 2 diabetic patients covered by Isfahan Endocrine and Metabolism Research Center in 1377]. Iran J Endocrine Metabolism. 1998;4(2).Persian.
19. Yeaw J, Halinan S, Hines D, Delozier A, Perez M, Boye M, et al. Direct medical costs for complications among children and adults with diabetes in the US commercial payer setting. Appl Health Econ Health Policy. 2014;12(2):219-30. [PubMed ID:24573912]. https://doi.org/10.1007/s40258-014-0086-9.
20. Caro JJ, Ward AJ, O’Brien JA. Lifetime costs of complications resulting from type 2 diabetes in the U.S. Diabetes Care. 2002;25(3):476-81. [PubMed ID:11874933]. https://doi.org/10.2337/diacare.25.3.476.
21. Hidayat B, Ramadani RV, Rudijanto A, Soewondo P, Suastika K, Siu Ng JY. Direct Medical Cost of Type 2 Diabetes Mellitus and Its Associated Complications in Indonesia. Value Health Reg Issues. 2022;28:82-9. [PubMed ID:34839111]. https://doi.org/10.1016/j.vhri.2021.04.006.
22. Javanbakht M, Baradaran HR, Mashayekhi A, Haghdoost AA, Khamseh ME, Kharazmi E, Sadeghi A. Cost-of-illness analysis of type 2 diabetes mellitus in Iran. PLoS One. 2011;6(10):e26864. [PubMed ID:22066013]. [PubMed Central ID:PMC3204988]. https://doi.org/10.1371/journal.pone.0026864.
23. Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH. Poverty and access to health care in developing countries. Ann N Y Acad Sci. 2008;1136:161-71. [PubMed ID:17954679]. https://doi.
org/10.1196/annals.1425.011.
24. American Diabetes A. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033-46. [PubMed ID:23468086]. [PubMed Central ID:PMC3609540]. https://doi.org/10.2337/dc12-2625.
25. Chatterjee S, Riewpaiboon A, Piyauthakit P, Riewpaiboon W, Boupaijit K, Panpuwong N, Archavanuntagul V. Cost of diabetes and its complications in Thailand: a complete picture of economic burden. Health Soc Care Community. 2011;19(3):289-98. [PubMed ID:21276105]. https://doi.org/10.1111/j.1365-2524.2010.00981.x.
26. American Diabetes A. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care. 2018;41(5):917-28. [PubMed ID:29567642]. [PubMed Central ID:PMC5911784]. https://doi.org/10.2337/dci18-0007.
27. Al-Maskari F, El-Sadig M, Nagelkerke N. Assessment of the direct medical costs of diabetes mellitus and its complications in the United Arab Emirates. BMC Public Health. 2010;10:679. [PubMed ID:21059202]. [PubMed Central ID:PMC2988742]. https://doi.org/10.1186/1471-2458-10-679.
28. Bayazidi Y, Davari M. The Estimation of the Imposed Economic Burden Due to Inadequate Medical Care in Patients Suffering from Type 2 Diabetes in Tehran. Social Security Journal. 2020;15(4):121-31.
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| Issue | Vol 8 No 2 (2024) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/htaa.v8i2.15630 | |
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How to Cite
1.
Ghorbani S, Rezapour A, Jahangiri R, Bagheri Faradonbeh S, Ghotbiyan N, Saeedian E. Estimating the Economic Burden of Type 2 Diabetes Among the Elderly in Tehran Province. Health Tech Ass Act. 2024;8(2).
