Insights for Care:The Healthcare Utilisation and Cost Impact of Managing Type 2 Diabetes-Associated Microvascular Complications


Introduction: The increasing prevalence of type 2 diabetes (T2DM) in the UK imposes a significant burden on the National Health Service (NHS). Despite the availability of effective treatments, the loss of glycaemic control over time results in significant comorbidities, including nephropathy, neuropathy and retinopathy. The cost of treating these microvascular complications has not been well documented, and this study aimed to provide an accurate assessment of the healthcare resource utilisation (HCRU) associated with managing T2DM and its complications. Methods: This retrospective cohort study utilised electronic medical records from patients with T2DM from the Heart of England Foundation Trust (HEFT), which captures data from patients using secondary care services. Patients were diagnosed with microvascular complications based on ICD-10 or OPCS codes. HCRU over a 2-year period was based on NHS Tariffs for healthcare services for inpatient, accident and emergency, and dialysis clinic usage. Results: The study cohort comprised 26,629 patients with T2DM who used HEFT services during the study period, 22.6%, 20.8% and 3.1% of whom had comorbid nephropathy, retinopathy or neuropathy, respectively. While the prevalence of diabetes in the overall HEFT population was reported to be 7% in 2012, diabetes and its associated complications accounted for more than 30% of secondary care costs. Furthermore, while patients with diabetes represent only 17% of HEFT inpatients, they account for more than 20% of service usage. The economic burden of microvascular complications increased substantially with the severity of the condition, with the overall cost exceeding £70 million over the 2-year period. Conclusion: This study of patients with T2DM in a typical secondary care provider in the UK showed that avoiding the progression of microvascular complications could provide substantial cost savings through targeted interventions that improve outcomes and lower resource use. Funding: Merck Sharp & Dohme Limited.

Publication DOI:
Divisions: College of Health & Life Sciences > School of Biosciences
College of Health & Life Sciences
College of Health & Life Sciences > Chronic and Communicable Conditions
Additional Information: © The Author(s) 2019
Uncontrolled Keywords: Diabetic complications,Healthcare resource utilisation,Insights for care,Microvascular complications,Nephropathy,Neuropathy,Real world data,Retinopathy,Type 2 diabetes,Internal Medicine,Endocrinology, Diabetes and Metabolism
Publication ISSN: 1869-6953
Full Text Link:
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
https://link.sp ... 3300-018-0548-4 (Publisher URL)
PURE Output Type: Article
Published Date: 2019-04-01
Accepted Date: 2019-02-08
Authors: Chapman, David
Foxcroft, Roland
Dale-Harris, Laura
Ronte, Hanno
Bidgoli, Farid
Bellary, Srikanth (ORCID Profile 0000-0002-5924-5278)



Version: Published Version

License: Creative Commons Attribution

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