OBJECTIVE This study updates previous estimates of the economic burden of diagnosed diabetes and quantifies the increased health resource use and lost productivity associated with diabetes in 2012. RESEARCH DESIGN AND METHODS The study uses a prevalence-based approach that combines the demographics of the U.S. population in 2012 with diabetes prevalence, epidemiological data, health care cost, and economic data into a Cost of Diabetes Model. Health resource use and associated medical costs are analyzed by age, sex, race/ethnicity, insurance coverage, medical condition, and health service category. Data sources include national surveys, Medicare standard analytical files, and one of the largest claims databases for the commercially insured population in the U.S. RESULTS The total estimated cost of diagnosed diabetes in 2012 is $245 billion, including $176 billion in direct medical costs and $69 billion in reduced productivity. The largest components of medical expenditures are hospital inpatient care (43% of the total medical cost), prescription medications to treat the complications of diabetes (18%), antidiabetic agents and diabetes supplies (12%), physician office visits (9%), and nursing/residential facility stays (8%). People with diagnosed diabetes incur average medical expenditures of about $13,700 per year, of which about $7,900 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures approximately 2.3 times higher than what expenditures would be in the absence of diabetes. For the cost categories analyzed, care for people with diagnosed diabetes accounts for more than 1 in 5 health care dollars in the U.S., and more than half of that expenditure is directly attributable to diabetes. Indirect costs include increased absenteeism ($5 billion) and reduced productivity while at work ($20.8 billion) for the employed population, reduced productivity for those not in the labor force ($2.7 billion), inability to work as a result of disease-related disability ($21.6 billion), and lost productive capacity due to early mortality ($18.5 billion). CONCLUSIONS The estimated total economic cost of diagnosed diabetes in 2012 is $245 billion, a 41% increase from our previous estimate of $174 billion (in 2007 dollars). This estimate highlights the substantial burden that diabetes imposes on society. Additional components of societal burden omitted from our study include intangibles from pain and suffering, resources from care provided by nonpaid caregivers, and the burden associated with undiagnosed diabetes.

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2012年美国糖尿病的经济成本

目的本研究更新了先前对诊断出的糖尿病的经济负担的估计，并量化了2012年与糖尿病相关的增加的卫生资源使用和生产力损失。研究设计和方法本研究采用了一种基于流行率的方法，该方法结合了美国人口统计数据。 2012年，将糖尿病患病率，流行病学数据，医疗保健成本和经济数据纳入糖尿病成本模型。按年龄，性别，种族/民族，保险范围，医疗状况和健康服务类别分析健康资源使用和相关的医疗费用。数据来源包括国家调查，Medicare标准分析文件以及美国商业保险人群中最大的理赔数据库之一。结果2012年，诊断出的糖尿病总估计成本为2450亿美元，其中包括1,760亿美元的直接医疗费用和690亿美元的生产力下降。医疗支出的最大组成部分是医院住院治疗（占总医疗费用的43％），治疗糖尿病并发症的处方药（18％），抗糖尿病药和糖尿病用品（12％），医生就诊（9％） ，而护理/住宅设施的入住率则为8％。被诊断出患有糖尿病的人每年平均医疗开支约为13,700美元，其中约7,900美元归因于糖尿病。平均而言，被诊断出患有糖尿病的人的医疗费用大约是没有糖尿病的情况下医疗费用的2.3倍。对于所分析的费用类别，在美国，对诊断为糖尿病的人进行的护理占五分之一的医疗保健费用，其中一半以上的支出直接归因于糖尿病。间接成本包括增加的缺勤率（50亿美元）和工作人口生产力的下降（208亿美元），非劳动力人口的生产力下降（27亿美元），由于疾病相关的残疾而无法工作（ 216亿美元），以及由于早期死亡而导致的生产能力损失（185亿美元）。结论2012年诊断出的糖尿病的总经济成本估计为2450亿美元，比我们之前估计的1740亿美元（以2007年美元为准）增加了41％。该估计突出了糖尿病给社会带来的巨大负担。我们的研究中省略了社会负担的其他组成部分，包括痛苦和苦难中的无形资产，无薪照护者提供的照护资源，