Journal article
Body mass index and insulin use as identifiers of high‐cost patients with type 2 diabetes: A retrospective analysis of electronic health records linked to insurance claims data
Diabetes, obesity & metabolism, Vol.21(6), pp.1419-1428
06/2019
DOI: 10.1111/dom.13671
PMID: 30768824
Abstract
Aims
To study the association of body mass index (BMI) and insulin use with type 2 diabetes‐related healthcare expenditures (T2D‐HE).
Materials and methods
Retrospective study using de‐identified electronic health records linked to insurance claims data. Study included a prevalence‐based sample of overweight or obese patients with antihyperglycaemic‐treated T2D. Patients had ≥1 A1c measurement in 2014 (last observed = index A1c), ≥1 BMI measurement within ±90 days of index (average BMI = baseline BMI), and continuous enrolment for 180 days before (baseline) through 395 days after index (day 30‐395 = follow‐up). BMI was categorized as: 25 to 29.9 kg/m2 = overweight; 30 to 34.9 kg/m2 = obese class I (OCI); 35 to 39.9 kg/m2 = OCII; ≥40 kg/m2 = OCIII. Multivariable regressions were used to examine one‐year follow‐up T2D‐HE as a function of BMI, insulin use, an interaction term between BMI and insulin use, and patient demographics.
Results
Study included 13 026 patients (mean age = 63.6 years; 48.1% female; 29.5% overweight, 31.6% OCI, 20.3% OCII, 18.6% OCIII; 25.3% insulin users). Baseline insulin use rates monotonically ranged from 19.7% in overweight patients to 33.0% in OCIII patients (P < 0.001). Together, BMI and insulin use were jointly associated with one‐year follow‐up T2D‐HE, which monotonically ranged from $5842 in overweight patients with no insulin to $17 700 OCIII insulin users, P < 0.001. Within each BMI category, insulin users' one‐year T2D‐HE was at least double that of non‐users. Additional analyses of all‐cause healthcare expenditures yielded consistent results.
Conclusions
BMI and insulin use represent simple stratifiers for identifying high‐cost patients. OCIII insulin users incurred the greatest annual healthcare expenditures; these patients may be an ideal group for targeted interventions.
Details
- Title: Subtitle
- Body mass index and insulin use as identifiers of high‐cost patients with type 2 diabetes: A retrospective analysis of electronic health records linked to insurance claims data
- Creators
- Stephen S. Johnston - Johnson & Johnson (United States)Eric M. Ammann - Johnson & Johnson (United States)Sangeetha R. Kashyap - Cleveland ClinicAndrew Stokes - Boston UniversityCarine Chia‐Wen Hsiao - Ethicon Inc.Mehmet Daskiran - Johnson & Johnson (United States)Robin Scamuffa - Ethicon Inc.
- Resource Type
- Journal article
- Publication Details
- Diabetes, obesity & metabolism, Vol.21(6), pp.1419-1428
- DOI
- 10.1111/dom.13671
- PMID
- 30768824
- NLM abbreviation
- Diabetes Obes Metab
- ISSN
- 1462-8902
- eISSN
- 1463-1326
- Publisher
- Blackwell Publishing Ltd
- Number of pages
- 10
- Grant note
- Johnson & Johnson
- Language
- English
- Date published
- 06/2019
- Academic Unit
- Epidemiology
- Record Identifier
- 9984364430302771
Metrics
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