TY - JOUR
T1 - Life Expectancy and Lifetime Health Care Expenditures for Type 1 Diabetes
T2 - A Nationwide Longitudinal Cohort of Incident Cases Followed for 14 Years
AU - Ou, Huang Tz
AU - Yang, Chen Yi
AU - Wang, Jung Der
AU - Hwang, Jing Shiang
AU - Wu, Jin Shang
N1 - Publisher Copyright:
© 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR)
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Objectives To assess additional life expectancy (LE), expected years of life lost, and lifetime health care expenditures after type 1 diabetes diagnosis, stratified by sex and age of first diagnosis (early: 0–12 years; late: 13–40 years). Methods A longitudinal cohort of patients with diabetes was constructed from Taiwan's National Health Insurance Research Database of 1999 to 2012. The survival functions for diabetic patients and age- and sex-matched general population were estimated by using a semiparametric extrapolation method with annual life tables. The average monthly health care expenditures were multiplied by the corresponding monthly survival rates and summed to calculate the lifetime health care expenditures. Cox proportional hazard models were constructed to corroborate the effects of sex and age, after being adjusted for comorbidities, complications, and calendar years. Results A total of 2386 cases (45% early diagnosis, 49% males) were identified. An additional LE after diabetes diagnosis was 45.12 years, with an estimated 17.63 years of life lost. The predicted total and diabetes-related lifetime costs were $56,939 and $102,140, respectively. Early diagnosed patients had a longer LE and lower health care spending compared with those of late-diagnosed patients. Male patients had a shorter LE and a higher expected years of life lost than the female patients, which corresponded to lower lifetime costs for the former. The Cox model results for overall mortality corroborated these trends. Conclusions Early detection of type 1 diabetes and sex-specific strategies would probably improve long-term health outcomes and save on the cost of diabetes care.
AB - Objectives To assess additional life expectancy (LE), expected years of life lost, and lifetime health care expenditures after type 1 diabetes diagnosis, stratified by sex and age of first diagnosis (early: 0–12 years; late: 13–40 years). Methods A longitudinal cohort of patients with diabetes was constructed from Taiwan's National Health Insurance Research Database of 1999 to 2012. The survival functions for diabetic patients and age- and sex-matched general population were estimated by using a semiparametric extrapolation method with annual life tables. The average monthly health care expenditures were multiplied by the corresponding monthly survival rates and summed to calculate the lifetime health care expenditures. Cox proportional hazard models were constructed to corroborate the effects of sex and age, after being adjusted for comorbidities, complications, and calendar years. Results A total of 2386 cases (45% early diagnosis, 49% males) were identified. An additional LE after diabetes diagnosis was 45.12 years, with an estimated 17.63 years of life lost. The predicted total and diabetes-related lifetime costs were $56,939 and $102,140, respectively. Early diagnosed patients had a longer LE and lower health care spending compared with those of late-diagnosed patients. Male patients had a shorter LE and a higher expected years of life lost than the female patients, which corresponded to lower lifetime costs for the former. The Cox model results for overall mortality corroborated these trends. Conclusions Early detection of type 1 diabetes and sex-specific strategies would probably improve long-term health outcomes and save on the cost of diabetes care.
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U2 - 10.1016/j.jval.2016.05.017
DO - 10.1016/j.jval.2016.05.017
M3 - Article
C2 - 27987648
AN - SCOPUS:84998814294
SN - 1098-3015
VL - 19
SP - 976
EP - 984
JO - Value in Health
JF - Value in Health
IS - 8
ER -