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Nerat, Tomaž; Kos, Mitja
Zdravstveno varstvo, 09/2013, Volume: 52, Issue: 3Journal Article
Diabetes prevalence and costs are rising on aglobal scale. Therefore, it is necessary to periodically conduct cost studies for assessing the healthcare burden impact. In Slovenia, the last type 2 diabetes cost assessment was conducted in 2006, not including all diabetes complication costs. The aim of this study was to revise, update and compare to previously published datadirect healthcare costs of type 2 diabetes in Slovenia with additional complications costs consideration. The study was performed from the healthcare payer perspective using the bottom-up approach, was prevalence based and estimated direct medical costs. We estimated total yearly direct medical costs of type 2 diabetes in Slovenia to 99,120,419 euro with annual per capita costs of 834.70 euro. The highest cost shares were attributed to cardiovascular complication costs (21,683,919 euro), diabetes co-medication (20,977,269 euro) and diabetes treatment medication (18,505,015 euro). Highest yearly costs per complication (all cases, all occurrences) were estimated for dialysis I and III (9,162,635 euro), stroke first year costs (4,951,306 euro) and congestive heart failure first year costs (4,879,533 euro). Yearly per one patient, the complication costs were highest for kidney transplantation, followed by dialysis I and III (78,621.25 euro and 36,797.73 euro) In comparison to the costs published in the literature before, our estimated total yearly direct medical costs were comparable, although annual per capita costs were assessed lower than elsewhere. Further, regarding the complication costs estimations, our assessed expenses were comparable to those published in other countries. Prevalenca in stroški sladkorne bolezni v globalnem merilu naraščajo. Zato je treba redno izvajati študije stroškovnega bremena za oceno vpliva na zdravstvo. V Sloveniji je bila zadnja študija bremena sladkorne bolezni tipa 2 izvedena leta 2006 in ni upoštevala vseh stroškov diabetičnih zapletov. Cilj te raziskave je bil pregledati, posodobiti in primerjati s prej objavljenimi podatki neposredne medicinske stroške sladkorne bolezni tipa 2 v Sloveniji z upoštevanjem dodatnih diabetičnih zapletov. Študija je bila izvedena z vidika plačnika zdravstvenega varstva; uporabljen je bil pristop »bottom-up« s prevalenčnim vidikom in ocenjeni so bili neposredni medicinski stroški. Letne neposredne medicinske stroške sladkorne bolezni tipa 2 smo ocenili na 99,120.419 evrov z 834,70 evra letnih stroškov na osebo. Najvišji delež je pripadal stroškom srčno-žilnih zapletov (21,683.919 evrov), stroškom sočasno uporabljenih zdravil (20,977.269 evrov) in stroškom antidiabetikov in inzulinov (18,505.015 evrov). Najvišji letni stroški za diabetični zaplet (vse ponovitve in vsi primeri) so bili ocenjeni za dializo I in III (9,162.635 evrov), prvo leto možganske kapi (4.951.306 evrov) in prvo leto srčnega popuščanja (4,879.533 evrov). Najdražji zaplet sladkorne bolezni (letno na posameznega bolnika) je bila transplantacija ledvic (78.621,25 evra), sledili sta dializa I in III (letno na osebo 36.797,73 evra). V primerjavi s prej objavljenimi podatki v literaturi so v tej raziskavi objavljeni letni neposredni medicinski stroški primerljivi, čeprav so letni stroški na osebo ocenjeni nižje kot drugje. Prav tako so stroškovne ocene posameznih zapletov sladkorne bolezni primerljive s prej objavljenimi.
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