Advertisement
Research Article| Volume 258, P79-83, March 2017

Favorable cardiovascular risk factor profile is associated with lower healthcare expenditure and resource utilization among adults with diabetes mellitus free of established cardiovascular disease: 2012 Medical Expenditure Panel Survey (MEPS)

      Highlights

      • Those with DM were 8 times more likely to have poor CRF profiles than those without DM.
      • Presence of DM yielded high healthcare expenditure and resource utilization.
      • Improving CRF profile reduced cost independent of DM status.
      • Individuals with DM spent $2774 more than individuals without DM.

      Abstract

      Background and aims

      Given the prevalence and economic burden of diabetes mellitus (DM), we studied the impact of a favorable cardiovascular risk factor (CRF) profile on healthcare expenditures and resource utilization among individuals without cardiovascular disease (CVD), by DM status.

      Methods

      25,317 participants were categorized into 3 mutually-exclusive strata: “Poor”, “Average” and “Optimal” CRF profiles (≥4, 2–3, 0–1 CRF, respectively). Two-part econometric models were utilized to study cost data.

      Results

      Mean age was 45 (48% male), with 54% having optimal, 39% average, and 7% poor CRF profiles. Individuals with DM were more likely to have poor CRF profile vs. those without DM (OR 7.7, 95% CI 6.4, 9.2). Individuals with DM/poor CRF profile had a mean annual expenditure of $9,006, compared to $6,461 among those with DM/optimal CRF profile (p < 0.001).

      Conclusions

      A favorable CRF profile is associated with significantly lower healthcare expenditures and utilization in CVD-free individuals across DM status, suggesting that these individuals require aggressive individualized prescriptions targeting lifestyle modifications and therapeutic treatments.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Atherosclerosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Yang W.
        • Dall T.M.
        • Halder P.
        • et al.
        Economic costs of diabetes in the U.S. in 2012.
        Diabetes Care. 2013; 36: 1033-1046
        • Li R.
        • Zhang P.
        • Barker L.E.
        • et al.
        Cost-effectiveness of interventions to prevent and control diabetes mellitus: a systematic review.
        Diabetes Care. 2010; 33: 1872-1894
        • Valero-Elizondo J.
        • Salami J.A.
        • Ogunmoroti O.
        • et al.
        Favorable cardiovascular risk profile is associated with lower healthcare costs and resource utilization.
        2012 Med. Expend. Panel Surv. 2016; 9: 143-153
        • Stone N.J.
        • Robinson J.G.
        • Lichtenstein A.H.
        • et al.
        2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of cardiology/American heart association task force on practice guidelines.
        J. Am. Coll. Cardiol. 2014; 63: 2889-2934
        • Herman W.H.
        The cost-effectiveness of diabetes prevention: results from the diabetes prevention program and the diabetes prevention program outcomes study.
        Clin. Diabetes Endocrinol. 2015; 1: 9
        • Group, TDPPR
        The 10-year cost-effectiveness of lifestyle intervention or metformin for diabetes prevention: an intent-to-treat analysis of the DPP/DPPOS.
        Diabetes Care. 2012; 35: 723-730
        • Eckel R.H.
        • Jakicic J.M.
        • Ard J.D.
        • et al.
        2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of cardiology/American heart association task force on practice guidelines.
        J. Am. Coll. Cardiol. 2014; 63: 2960-2984
      1. Medical Expenditure Panel Survey, In.

      2. IRB Exemption, In.

        • Ozieh M.N.
        • Dismuke C.E.
        • Lynch C.P.
        • et al.
        Medical care expenditures associated with chronic kidney disease in adults with diabetes: United States 2011.
        Diabetes Res. Clin. Pract. 2015; 109: 185-190
        • Mihaylova B.
        • Briggs A.
        • O'Hagan A.
        • et al.
        Review of statistical methods for analysing healthcare resources and costs.
        Health Econ. 2011; 20: 897-916
        • Belloti F.
        • Deb P.
        • Manning W.G.
        • et al.
        Twopm: two-part models.
        Stata J. 2015; 15: 3-20
        • Hardin J.
        • HIilbe J.
        Generalized Linear Models and Extensions.
        StataCorp LP, Stata Press, College Station2007
        • Manning W.G.
        • Mullahy J.
        Estimating log models: to transform or not to transform?.
        J. health Econ. 2001; 20: 461-494
        • Trogdon J.G.
        • Murphy L.B.
        • Khavjou O.A.
        • et al.
        Costs of chronic diseases at the state level: the chronic disease cost calculator.
        Prev. Chronic Dis. 2015; 12: E140
        • Sing M.
        • Banthin J.S.
        • Selden T.M.
        • et al.
        Reconciling medical expenditure estimates from the MEPS and NHEA.
        Health care financ. Rev. 2002; 2006: 25-40
        • Aizcorbe A.
        • Liebman E.
        • Pack S.
        • et al.
        Measuring health care costs of individuals with employer-sponsored health insurance in the U.S.: a comparison of survey and claims data.
        Stat. J. IAOS. 2012; 28: 43-51