Medical Costs Among Youth Younger Than 20 Years of Age With and Without Diabetic Ketoacidosis at the Time of Diabetes Diagnosis

Details

• Alternative Title:
  Diabetes Care
• Personal Author:
  Saydah, Sharon H. ; Shrestha, Sundar S. ; Zhang, Ping ; Zhou, Xilin ; Imperatore, Giuseppina
• Description:
  OBJECTIVE
  
  While diabetic ketoacidosis (DKA) is common in youth at the onset of the diabetes, the excess costs associated with DKA are unknown. We aimed to quantify the health care services use and medical care costs related to the presence of DKA at diagnosis of diabetes.
  
  RESEARCH DESIGN AND METHODS
  
  We analyzed data from the U.S. MarketScan claims database for 4,988 enrollees aged 3–19 years insured in private fee-for-service plans and newly diagnosed with diabetes during 2010–2016. Youth with and without DKA at diabetes diagnosis were compared for mean health care service use (outpatient, office, emergency room, and inpatient visits) and medical costs (outpatient, inpatient, prescription drugs, and total) for 60 days prior to and 60 days after diabetes diagnosis. A two-part model using generalized linear regression and logistic regression was used to estimate medical costs, controlling for age, sex, rurality, health plan, year, presence of hypoglycemia, and chronic pulmonary condition. All costs were adjusted to 2016 dollars.
  
  RESULTS
  
  At diabetes diagnosis, 42% of youth had DKA. In the 60 days prior to diabetes diagnosis, youth with DKA at diagnosis had less health services usage (e.g., number of outpatient visits: −1.17; P < 0.001) and lower total medical costs (−$635; P < 0.001) compared with youth without DKA at diagnosis. In the 60 days after diagnosis, youth with DKA had significantly greater health care services use and health care costs ($6,522) compared with those without DKA.
  
  CONCLUSIONS
  
  Among youth with newly diagnosed diabetes, DKA at diagnosis is associated with significantly higher use of health care services and medical costs.
  
  
• Subjects:
  Adolescent Child Child, Preschool Cost Of Illness Databases, Factual Diabetes Mellitus, Type 1 Diabetic Ketoacidosis Female Health Care Costs Humans Linear Models Male Patient Acceptance Of Health Care Time Factors United States Young Adult

  More +
• Source:
  Diabetes Care. 42(12):2256-2261
• Pubmed ID:
  31575641
• Pubmed Central ID:
  PMC10999225
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  42
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:674b5dd3a674aeac2545ec22a51b1f04003dbebd8acc482613ae7b09028e36e4
• Download URL:
  https://stacks.cdc.gov/view/cdc/154104/cdc_154104_DS1.pdf
• File Type:
  [PDF - 432.63 KB ]