Medical care expenditures for diabetes, its chronic complications, and its comorbidities

Background. Medical expenditures for diabetes are estimated, including expenditures for chronic complications of diabetes, unrelated conditions for which diabetics are at higher risk, and various comorbidities that raise the cost of medical care. Methods. A variety of national data sources are used to disaggregate the Health Care Financing Administration's national health expenditures in 1995 by sex, age, and diagnosis. Expenditures for chronic complications and other unrelated conditions for which diabetics have higher rates of utilization are determined by analysis of attributable risks. Additional expenditures generated by extra hospital inpatient days and higher charges for nursing home and home health care for comorbidities are estimated by regression analyses. Sensitivity analysis is used to calculate a range of estimated expenditures. Results. Total expenditures attributed to diabetes are $47.9 billion in 1995, including $18.8 billion for first listed diabetes, $18.7 billion for chronic complications, $8.5 billion for unrelated conditions, and $1.9 billion for comorbidities. The range of total expenditures is $34.3 to $63.7 billion. Conclusions. Comprehensive accounting of expenditures more accurately assesses the economic burden of diabetes and potential savings from prevention, especially of chronic complications. This analysis is illustrative for other chronic illnesses.