The Costs of Type 2 Diabetes Mellitus Outpatient Care in the Brazilian Public Health System

The Costs of Type 2 Diabetes Mellitus Outpatient Care in the Brazilian Public Health System

Author Bahia, Luciana Ribeiro Google Scholar
Araujo, Denizar Vianna Autor UNIFESP Google Scholar
Schaan, Beatriz D'Agord Google Scholar
Dib, Sergio Atala Autor UNIFESP Google Scholar
Negrato, Carlos Antonio Google Scholar
Leao, Marluce P. S. Google Scholar
Ramos, Alberto José Santos Google Scholar
Forti, Adriana Costa e Autor UNIFESP Google Scholar
Gomes, Marilia de Brito Google Scholar
Foss, Maria Cristina Google Scholar
Monteiro, Rosane Aparecida Google Scholar
Sartorelli, Daniela Saes Google Scholar
Franco, Laercio Joel Autor UNIFESP Google Scholar
Institution Universidade do Estado do Rio de Janeiro (UERJ)
Univ Fed Rio Grande do Sul
Universidade Federal de São Paulo (UNIFESP)
Associacao Diabet Bauru
Univ Estadual Santa Cruz
Univ Fed Campina Grande
Univ Estadual Ceara
Universidade de São Paulo (USP)
Abstract Objective: the prevalence of type 2 diabetes has shown a significant increase in parallel with health care costs. the objective of the Brazilian Study on Diabetes Costs (ESCUDI study) was to estimate direct and indirect costs of type 2 diabetes outpatient care in the Brazilian Public Health Care System. Methods: Data were collected from different levels of health care in eight Brazilian cities in 2007. A total of 1000 outpatients were interviewed and had their medical records data analyzed. Direct medical costs included expenses with medications, diagnostic tests, procedures, blood glucose test strips, and office visits. Nonmedical direct costs included expenses with diet products, transportation, and caregivers. Absenteeism, sick leave, and early retirement were classified as indirect costs. Results: Total annual cost for outpatient care was US$2108 per patient, out of which US$1335 per patient of direct costs (63.3%) and US$773 per patient of indirect costs (36.7%). Costs escalated as duration of diabetes and level of health care increased. Patients with both microvascular and macrovascular complications had higher costs (US$3199 per patient) compared to those with either microvascular (US$2062 per patient) or macrovascular (US$2517 per patient) complications only. the greatest portion of direct costs was attributed to medication (48.2%). Conclusions: Diabetes treatment leads to elevated costs both to Brazilian Public Health Care System and society. Costs increased along with duration of disease, level of care and presence of chronic complications, which suggested a need to reallocate health resources focusing on primary prevention of diabetes and its complications.
Keywords Brazil
outpatient care
type 2 diabetes
Language English
Sponsor Brazilian Diabetes Society
Sanofi Aventis
Eli Lilly pharmaceuticals
Date 2011-07-01
Published in Value in Health. New York: Elsevier B.V., v. 14, n. 5, p. S137-S140, 2011.
ISSN 1098-3015 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent S137-S140
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000299081000031

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