PDB73 - Incremental Burden of Diabetes Complications on Quality of Life and Healthcare Expenditures in the United States

Abstract

To estimate the treated prevalence of diabetes complications, evaluate the impact of diabetes complications on health-related quality of life (HRQOL), and quantify the incremental cost of diabetes complications in a large nationally representative sample of adults with diabetes in the US. We identified adults (≥18 years) with diabetes using pooled 2013-2015 Medical Expenditure Panel Survey (MEPS) data. Diabetes complications were ascertained using Clinical Classification Codes (CCC). HRQOL scores were measured using SF-12v2. HRQOL domain, physical component summary (PCS), and mental component summary (MCS) scores were calculated using norm-based scoring technique. Multivariable linear regression analyses were conducted to assess the impact of diabetes complications on HRQOL. Generalized linear model with a gamma distribution and log link function was used to quantify the average annual total health care cost associated with diabetes complications. All analyses were adjusted using MEPS design variables and sampling weights. In US annual treated prevalence of diabetes in adults was 21.1 million, of which 4.7 million adults had diabetes-related complications. Age, BMI, employment, region, and insurance were clinically meaningful (≥3.0 points difference) predictors of HRQOL in adults with diabetes complications. Adults with diabetes complications had significantly lower adjusted mean PCS (-4.7) and MCS (-1.5) scores as compared to those without complications. The negative impact of diabetes complications was statistically and clinically meaningful for domains of general health (-5.1 points), physical functioning (-4.6 points), role-physical (-4.0 points), and bodily pain (-3.0 points). The average annual total cost was $8,955.08 per person (P < 0.001) higher in adults with diabetes complications as compared to adults without diabetes complications. Diabetes complications are associated with significant adverse impact on mean composite scores and all 8 domain scores of HRQOL and result in significantly greater average annual total health care cost among adult patients with diabetes.