Predictors of direct costs of diabetes care in pediatric patients with type 1 diabetes

Anita K. Ying, David R. Lairson, Angelo P. Giardino, Melissa L. Bondy, Irum Zaheer, Morey W. Haymond, Rubina A. Heptulla

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objective: This study examines factors that predict elevated direct costs of pediatric patients with type 1 diabetes. Methods: A cohort of 784 children with type 1 diabetes at least 6 months postdiagnosis and managed by pediatric endocrinologists at Texas Children's Hospital were included in this study. Actual reimbursed costs from January 2004 to December 2005 were obtained. Medication and supply costs were based on estimates from insulin dosage and type of insulin regimen prescribed, respectively. We examined utilization of care, total diabetes-related direct medical costs, and predictors of direct costs and hospitalization. Results: Annually, 7% (58/784) of patients (excluding initial hospitalization at diagnosis) had a diabetes-related hospitalization and median length of stay was days. Mean total diabetes-related direct cost per person-year was $4730 [95% confidence interval (CI), 4516-4944]. Supplies accounted for 38% and medications 33% of costs, respectively. Older age, hemoglobin A1C (HbA1C) > 8.5%, use of a multi-injection or pump regimen, living in a non-married household, and female gender were associated with higher annual costs. HbA1C > 8.5%, living in a non-married household, and female gender increased the odds of a diabetes-related hospitalization. Discussion: Better metabolic control in patients with type 1 diabetes was associated with lower direct medical costs and lower odds of hospitalization. Marital status of the primary caregiver, irrespective of type of insurance, impacts the patient's healthcare costs and risk of hospitalization. This large single-center US study analyzes cost distribution in children with diabetes and is informative for payers and providers focused on effective management and improving healthcare costs.

Original languageEnglish (US)
Pages (from-to)177-182
Number of pages6
JournalPediatric Diabetes
Volume12
Issue number3 PART 1
DOIs
StatePublished - May 2011
Externally publishedYes

Fingerprint

Type 1 Diabetes Mellitus
Pediatrics
Costs and Cost Analysis
Hospitalization
Health Care Costs
Hemoglobins
Insulin
Marital Status
Insurance
Caregivers
Length of Stay
Confidence Intervals
Injections

Keywords

  • CI
  • Cost of illness
  • ER
  • HbA
  • Hospitalization
  • ICU
  • Insurance
  • OR
  • Outpatient
  • TCH
  • TDD
  • Third-party payers
  • Type 1 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism

Cite this

Ying, A. K., Lairson, D. R., Giardino, A. P., Bondy, M. L., Zaheer, I., Haymond, M. W., & Heptulla, R. A. (2011). Predictors of direct costs of diabetes care in pediatric patients with type 1 diabetes. Pediatric Diabetes, 12(3 PART 1), 177-182. https://doi.org/10.1111/j.1399-5448.2010.00680.x

Predictors of direct costs of diabetes care in pediatric patients with type 1 diabetes. / Ying, Anita K.; Lairson, David R.; Giardino, Angelo P.; Bondy, Melissa L.; Zaheer, Irum; Haymond, Morey W.; Heptulla, Rubina A.

In: Pediatric Diabetes, Vol. 12, No. 3 PART 1, 05.2011, p. 177-182.

Research output: Contribution to journalArticle

Ying, AK, Lairson, DR, Giardino, AP, Bondy, ML, Zaheer, I, Haymond, MW & Heptulla, RA 2011, 'Predictors of direct costs of diabetes care in pediatric patients with type 1 diabetes', Pediatric Diabetes, vol. 12, no. 3 PART 1, pp. 177-182. https://doi.org/10.1111/j.1399-5448.2010.00680.x
Ying AK, Lairson DR, Giardino AP, Bondy ML, Zaheer I, Haymond MW et al. Predictors of direct costs of diabetes care in pediatric patients with type 1 diabetes. Pediatric Diabetes. 2011 May;12(3 PART 1):177-182. https://doi.org/10.1111/j.1399-5448.2010.00680.x
Ying, Anita K. ; Lairson, David R. ; Giardino, Angelo P. ; Bondy, Melissa L. ; Zaheer, Irum ; Haymond, Morey W. ; Heptulla, Rubina A. / Predictors of direct costs of diabetes care in pediatric patients with type 1 diabetes. In: Pediatric Diabetes. 2011 ; Vol. 12, No. 3 PART 1. pp. 177-182.
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