Outcome Research in Diabetes / 임상당뇨병

ABSTRACT

Economic development has lead to increased life expectancy, population growth, and spread of the Western life style, resulting in a gradual increase of diabetic patients during the last three decades. Outcome research focusing on the economics of the medical field began in mid the 1990s, including publications about costs, cost-effectiveness analysis, and policy reflection. According to the ADA, direct cost spending on diabetes was $91.8 billion in 2002 and is projected to be $156 billion in 2010 and $192 billion in 2020. In Canada, research found that the direct cost of diabetic care was $2.6 million (American dollars) in 1998, 7.8% of the total Canadian medical expenditure. Half of this cost was incurred in hospitals (IPD 19%, medication 31%). Recent domestic studies have analyzed the expenses associated with type 2 diabetes in some general hospitals. Type 2 diabetic patients, without complication, spend about 1,184,563 won annually on healthcare. On the other hand, patients with microvascular diseases spend up to 4.7 times as much, and patients with macrovascular disease incur up to 10.7 times greater costs. Patients with both complications have been shown to pay 8.8 times more than do those with no complications. The increased costs charged to kidney transplant patients was about 23.1 times greater than for those with no complications, while dialysis increased costs by 21 times, macrovascular disease with PTCA or CABG resulted in a 12.4-fold increase, and BKA was 11.8-fold more expensive. The total medical costs have soared with the treatment progress of diabetic retinopathy or nephropathy. In diabetic treatments, complication occurrence ultimately has an effect on the QOL, the patient mortality, and is associated with the direct medical expenses. Thus it is critical not to delay care in diabetic patients in order to avoid increased direct medical costs. Therefore, in diabetic care, as outlined in the medical care plan policy, it is most critical to adequately control blood sugar, blood pressure, and cholesterol in conjunction with the early discovery of any complications through the appropriate management techniques.