Medical care expenditures for diabetes, its chronic complications, and itscomorbidities

Background. Medical expenditures for diabetes are estimated, including expe nditures for chronic complications of diabetes, unrelated conditions for wh ich diabetics are at higher risk, and various comorbidities that raise the cost of medical care. Methods. A variety of national data sources are used to disaggregate the He alth Care Financing Administration's national health expenditures in 1995 b y sex, age, and diagnosis. Expenditures for chronic complications and other unrelated conditions for which diabetics have higher rates of utilization are determined by analysis of attributable risks. Additional expenditures g enerated by extra hospital inpatient days and higher charges for nursing ho me and home health care for comorbidities are estimated by regression analy ses. Sensitivity analysis is used to calculate a range of estimated expendi tures. Results. Total expenditures attributed to diabetes are $47.9 billion in 199 5, including $18.8 billion for first listed diabetes, $18.7 billion for chr onic complications, $8.5 billion for unrelated conditions, and $1.9 billion for comorbidities. The range of total expenditures is $34.3 to $63.7 billi on. Conclusions. Comprehensive accounting of expenditures more accurately asses ses the economic burden of diabetes and potential savings from prevention, especially of chronic complications. This analysis is illustrative for othe r chronic illnesses.