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The Economics of Diabetes Mellitus:
An Annotated Bibliography
INTRODUCTION
Preface
Diabetes
mellitus is a common, serious, and costly disease. An estimated 16 million
Americans, or nearly 6 percent of the population, have diabetes, and the
disease costs the nation nearly $100 billion annually. The prevalence
has increased dramatically over the last three decades, and minority groups
are disproportionately affected. Diabetes is the seventh leading cause
of death and can decrease the life expectancy by 5 to 15 years. It is
the leading cause of nontraumatic lower extremity amputations, renal failure,
and blindness in working-age adults. Diabetes is also a major cause of
premature mortality, stroke, cardiovascular disease, peripheral vascular
disease, congenital malformations, perinatal mortality, and long- and
short-term disability. In addition, persons with diabetic complications
have a lower quality of life compared with persons without diabetes.
Interventions
to reduce the burden of diabetes currently exist. Early detection and
treatment of eye disease, kidney disease, and lower extremity disease
can prevent or delay the development of blindness, kidney failure, and
amputation. However, far too often, the level of care needed to decrease
these complications is not reached. Because of the serious acute and chronic
complications, persons with diabetes tend to use more health services
than persons without diabetes. These resources include hospitalizations,
emergency room and outpatient clinic visits, laboratory tests, medication,
and self-management supplies (e.g., equipment to self-monitor blood glucose).
The cost to care for diabetes exacts a tremendous burden on both the patient
and payer. Several studies over the years have found that the direct health
care costs (costs of medical treatment and services) related to diabetes
are high.
In this era
of limited resources and escalating costs, it is critical to have an understanding
of the economics of diabetes in order to develop and implement sound public
health and prevention policies. However, studying these economics presents
several challenges, such as collecting the appropriate epidemiological
and cost data, determining the diabetes attributable factors for premature
morbidity and mortality, and determining methods to account for premature
morality, disability, and reduced quality of life.
This bibliography
includes most of the important economic studies currently available. In
the past, methods used for conducting economic research were not well
standardized. Although recent efforts, such as those by the Panel on Cost
Effectiveness in health and Medicine, have moved forward the use of standard
methodologies, much of the current literature in this bibliography and
elsewhere still requires careful review of the methods. Preparation of
this bibliography included contributions by experts in the field who reviewed
the entries for pertinency and accuracy. We acknowledge and appreciate
the contributions of
- Thomas
Songer, Ph.D., Department of Epidemiology, University of Pittsburgh,
Pittsburgh, Pennsylvania.
- William
H. Herman, M.D., M.P.H., Division of Endocrinology and Metabolism, Department
of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
- Christine
Tobin, Diabetes Control Services, Atlanta, Georgia.
It is hoped
that this bibliography will help identify major gaps in our knowledge
and will assist with the development of future diabetes economic research.
It also should be of assistance to public health professionals, clinicians,
insurers, economists, and researchers in their efforts to create effective
policy and to answer preventive questions.
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Page last modified: December 20, 2005
Content Source: National Center for Chronic Disease Prevention and Health Promotion
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