ESPE Abstracts (2014) 82 P-D-2-3-347

Predictors of Direct Costs of Pediatric Diabetes in Greece

Feneli Karachalioua, Konstantinos Athanasakisb, Charalabos Tsendidisc, Maria Kitrac, Stefanos Michalacosa & Kyriaki Karavanakic

aDepartment of Endocrinology-Growth and Development, ‘P & A Kyriakou’ Children’s Hospital, Athens, Greece; bDepartment of Health Economics National School of Public Health, Athens, Greece; cDiabetic Clinic, 2nd Department of Pediatrics, University of Athens, ‘P & A Kyriakou’ Children’s Hospital, Athens, Greece

Bakground: There is a dearth of data examining the direct costs of diabetes type 1 (T1DM) in Greece and their predictors.

Objective and hypotheses: To examine the predictors of elevated direct costs of T1DM in the National Health System in Greece.

Method: All patients diagnosed with T1DM, who were followed in the Diabetic Clinic of the University Pediatric Department of one of the two major Children’s hospitals in Athens, from 1st January 2011 to 31st December 2012 were included. Data on age, gender, ethnicity, insulin dosage and type of insulin regimen, outpatient visits and hospital diabetes-related admissions, laboratory tests and supplies costs were collected. Metabolic control was estimated as the mean of all HbA1c measurements obtained for each patient over the 2-years study period.

Results: Total diabetes-related direct costs per person-year (pppy) were estimated at [eurosign]2 712 (95% CI 2468–2956). The mean number of hospitalization days pppy was 0.067 (95% CI: 0.03–0.1) and the mean length of hospitalization 0.18 days pppy (95% CI: 0.05–0.3) The mean number of outpatient visits pppy was 2.88 (95% CI: 2.5–3.2). Multivariate linear regression analysis showed that total costs were significantly higher for i) pump therapy (P<0.0001), ii)older age (P<0.001) and iii) daily insulin dose (P<0.001). Patients on pump therapy had significantly higher cost [eurosign]5538.2 (1377.0) compared to patients on multi-injection [eurosign]2446.8 (537.0) and conventional regimen [eurosign]1978.5 (386.1) (P=0.000). Patients on pump therapy had better glycaemic control compared to the rest of patients (t=−2.101, P=0.039).

Conclusion: The main factor that predicted direct cost of diabetes care in our study was the type of insulin regimen and especially the use of pump. Supply costs accounted for the majority of annual direct costs. However, it is noteworthy that the use of pump was associated with better glycaemic control, which has to be co-estimated, since long-term microvascular complications constitute the major component of the total long-term diabetes care cost.

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