Medical Expenditures Associated With Diabetes Acute Complications in Privately Insured US Youth

OBJECTIVE - To estimate medical expenditures attributable to diabetes ketoacidosis (DKA) and severe hypoglycemia among privately insured insulin-treated U S youth with diabetes RESEARCH DESIGN AND METHODS - We analyzed the insurance claims of 7 556 youth age <= 19 years with insulin-treated diabetes The youth were continuously enrolled in fee-for service health plans and claims were obtained from the 2007 U S Market Scan Commercial Claims and Encounter database We used regression models to estimate total medical expenditures and their subcomponents outpatient inpatient and drug expenditures The ex cess expenditures associated with DKA and severe hypoglycemia were estimated as the difference between predicted medical expenditures for youth who did/did not experience either DKA or severe hypoglycemia RESULTS - For youth with and without DKA respectively predicted mean annual total medical expenditures were $14 236 and $8 398 (an excess of $5 837 for those with DKA) The excess was statistically greater for those with one or more episodes of DKA ($8 455) than among those with only one episode ($3 554) Predicted mean annual total medical expenditures were $12 850 and $8 970 for youth with and without severe hypoglycemia respectively (an excess of $3 880 for those with severe hypoglycemia) The excess was greater among those with one or more episodes ($5 929) than among those with only one ($2 888) CONCLUSIONS - Medical expenditures for potentially preventable DKA and severe hypoglycemia in U S youth with insulin-treated diabetes are substantial Improving the quality of care for these youth to prevent the development of these two complications could avert substantial U S health care expenditures