Estimating the cost of complications of diabetes in Australia using administrative health-care data

Objective: To estimate Australian health-care costs in the year of first occurrence and subsequent years for major diabetes-related complications using administrative health-care data. Methods: The costs were estimated using administrative information on hospital services and primary health-care services financed through Australia's national health insurance system Medicare. Data were available for 70,340 patients with diabetes in Western Australia (mean duration of 4.5 years of follow-up). Multiple regression analysis was used to estimate inpatient and primary care costs. Results: For a man aged 60 years, the average costs in the year the event first occurred were: amputation $20,416 (95% CI 18,670-22,411); nonfatal myocardial infarction (MI) $11,660 (10,931-12,450); nonfatal stroke $14,012 (12,849-15,183); ischaemic heart disease $12,577 (12,026-13,123); heart failure $15,530 (13,965-17,009); renal failure $28,661 (22,989-34,202); and chronic leg ulcer $15,413 (13,089-18,123). The costs in subsequent years for a man aged 60 years range from 14% for nonfatal MI to 106% for renal failure, of event costs. Conclusions: Estimates of the health-care costs associated with diabetes-related complications can be used in modeling the long-term costs of diabetes and in evaluating the cost-effectiveness of improving care.