COSTS OF DIABETES IN TEXAS, 1992

OBJECTIVE - To estimate direct and indirect costs of diabetes in Texas in 1992. RESEARCH DESIGN AND METHODS - For most direct medical costs, we relied on third party and provider billing databases, including Me dicare, Medicaid, VA facilities, public hospitals, and others. The res earchers identified people with diabetes in the respective databases, located all records of their care, and sorted records as clearly proba bly, or probably not attributable to diabetes on the basis of principa l diagnoses. In most cases, costs were valued as allowable or paid cha rges. Some medical costs, such as private insurance, were estimated fr om national data and state surveys. Indirect costs included current sh ort- and long-term disability costs and the discounted present value o f future costs of mortality Disability estimates relied on National He alth Interview Survey (NHIS) data and U.S. Department of Labor wage da ta applied to Texas. Mortality estimates were based on death certifica tes. RESULTS - Total costs clearly or probably attributable to diabete s among Texans in 1992 were estimated at $4.0 billion. Direct medical costs were similar to$1.6 billion. Indirect costs were estimated at $2 .4 billion. The largest direct costs were paid by Medicare. Most indir ect costs were from long-term disability. CONCLUSIONS - This study dem onstrates methods for conducting cost of illness studies at the state level. In a state like Texas, with a large and growing Mexican-America n population, estimation of current and future economic costs of diabe tes is vital for development of strategies to minimize social and econ omic consequences of diabetes.