Excess costs of medical care 1 and 8 years after diagnosis of diabetes: estimates from young and middle-aged incidence cohorts in Sweden

To analyze the excess costs of medical care during the first decade after d iabetes diagnosis, we surveyed two national incidence cohorts who contracte d diabetes at age of 15-34 years and matched control groups from the genera l population of Sweden. Ninety percent of the diabetic subjects were on ins ulin treatment. Data on healthcare utilization and use of glucose lowering drugs and medical devices were collected via a questionnaire mailed to a re cent cohort 1 year after diagnosis and a previously registered cohort 8 yea rs after diagnosis. Costing was based on average national costs of hospital inpatient and out-patient care, an original study of daycare costs, and sa les prices of the National Corporation of Swedish Pharmacies. One year afte r diabetes diagnosis, the annual excess costs of care were US$4743 among me n and US$4976 among women (1997 prices). Hospital inpatient care accounted for more than 50% of the excess costs. Eight years after diagnosis, the exc ess costs were US$2010 among men and US$2734 among women. The higher costs for women were mainly related to hospital out-patient care. but also to mor e intensive self-monitoring. We conclude that diabetes in young and middle- aged people is a major economic challenge even before significant complicat ions may have developed. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.