Abstract
Long-term health and economic consequences of diabetes mellitus are of significant importance to health policy makers to identify the most efficient interventions for disease managements. However, existing data are mainly from simulation models instead of "real-world" data. The objective of this study was to longitudinally evaluate the changes of prevalence of diabetic complications and associated healthcare costs in a nationally-representative diabetic cohort. We used the 2000-2011 Taiwan's Longitudinal Health Insurance Database (LHID) to conduct a population-based cohort study of 136,372 patients with type 2 diabetes. Diabetic complications of each patient were calculated annually after the cohort entry by the adapted Diabetes Complications Severity Index (aDCSI) score (sum of diabetic complication with severity levels, range 0-13) using diagnostic codes recorded in the LHID. Study subjects were further categorized into six subgroups according to their aDCSI score (0, 1, 2, 3, 4, 5+) at cohort entry. Healthcare utilizations (including outpatient and inpatient visits) as well as direct medical costs for the six subgroups were estimated annually using patient-level data from the LHID. We found the severity of diabetic complicat...Continue Reading
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