The prevalence and related direct medical costs of chronic complications among patients with type 2 diabetes in China

Objective To estimate the prevalence and related direct medical costs of chronic complications, especially cardiovascular diseases, cerebrovascular diseases, and nephropathy in patients with type 2 diabetes mellitus(T2DM) in China. Method Data were extracted from the hospital information system(HIS) database of 4 top level Chinese hospitals from January 1st, 2012 to May 31st, 2017. Patients with T2DM were identified through international classification of diseases, tenth version(ICD-10) diagnosis supplemented with Chinese descriptions. The prevalences of complications including cardiovascular diseases, cerebrovascular diseases, nephropathy, diabetic foot, lower extremity vascular diseases, diabetic retinopathy, and diabetic neuropathy were estimated among all identified patients with T2DM. The costs per hospitalization and per outpatient visit under the primary diagnoses of each chronic complication were further estimated. Results There were 61 139 patients with T2DM, with mean age of(62.1±13.6) years, 50.5% being males. 66.8% of them had chronic complications, and patient suffered from more than 2 complications on average. The most common complication was nephropathy(30.5%), followed by diabetic neuropathy(26.8%), diabetic retinopathy(26.3%), cardiovascular disease(24.9%), and cerebrovascular disease(19.2%). The cost per hospitalization was highest for cardiovascular disease(21 176 yuan), followed by diabetic foot disease(18 999 yuan) and cerebrovascular disease(16 583 yuan). The cost per outpatients visit varied from 826 to 976 yuan across different complications except for lower extremity vascular diseases(522 yuan). Conclusions The majority of patients with T2DM suffered from chronic complications. The occurrence and development of chronic complications, especially cardiovascular diseases, cerebrovascular diseases, and nephropathy, led to increased direct medical costs among patients with T2DM. Effective interventions, such as regular physical examinations and proper glycemic control, should be implemented to prevent complications among the diabetic patients. Key words: Diabetes mellitus, type 2; Chronic complications; Cardiovascular diseases; Cerebrovascular diseases; Nephropathy; Direct medical costs