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Article: Age-specific associations between the number of co-morbidities, all-cause mortality and public direct medical costs in patients with type 2 diabetes: A retrospective cohort study

TitleAge-specific associations between the number of co-morbidities, all-cause mortality and public direct medical costs in patients with type 2 diabetes: A retrospective cohort study
Authors
Keywordsdatabase research diabetes complications population study primary care type 2 diabetes
Issue Date2023
Citation
Diabetes, Obesity and Metabolism, 2023, v. 25, n. 2, p. 454-467 How to Cite?
AbstractAim: To evaluate the association between the number of co-morbidities, all-cause mortality and public health system expenditure in patients with type 2 diabetes (T2D) across different age groups. Materials and Methods: A retrospective observational study of T2D patients using electronic health records in Hong Kong was conducted. Patients were stratified by age (< 50, 50-64, 65-79, ≥ 80 years) and the number of co-morbidities (0, 1, 2, 3, ≥ 4), defined using the Charlson Comorbidity Index and prevalent chronic diseases identified in local surveys. The association between the number of co-morbidities, all-cause mortality and direct medical costs was examined using Cox proportional hazard regression and the gamma generalized linear model with log link function. Results: A total of 262 212 T2D patients with a median follow-up of 10 years were included. Hypertension and dyslipidaemia were the most common co-morbidities in all age groups. After age stratification, cardiovascular diseases dominated the top pair of co-morbidities in the older age groups (65-79 and ≥ 80 years), while inflammatory and liver disease were predominant among younger individuals. Compared with co-morbidity–free T2D patients, the hazard ratios (95% CI) of death for patients aged younger than 50 and 80 years or older with two co-morbidities were 1.31 (1.08-1.59) and 1.25 (1.15-1.36), respectively, and increased to 3.08 (2.25-4.21) and 1.98 (1.82-2.16), respectively, as the number of co-morbidities increased to four or more. Similar trends were observed for medical costs. Conclusions: Age-specific co-morbidity patterns were observed for patients with T2D. A greater number of co-morbidities was associated with increased mortality and healthcare costs, with stronger relationships observed among younger patients.
Persistent Identifierhttp://hdl.handle.net/10722/345286
ISSN
2023 Impact Factor: 5.4
2023 SCImago Journal Rankings: 2.079
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorHong, Sabrina Nan-
dc.contributor.authorMak, Ivy Lynn-
dc.contributor.authorChin, Weng Yee-
dc.contributor.authorYu, Esther Yee Tak-
dc.contributor.authorTse, Emily Tsui Yee-
dc.contributor.authorChen, Julie Yun-
dc.contributor.authorWong, Carlos King Ho-
dc.contributor.authorChao, David Vai Kiong-
dc.contributor.authorTsui, Wendy Wing Sze-
dc.contributor.authorLam, Cindy Lo Kuen-
dc.contributor.authorWan, Eric Yuk Fai-
dc.date.accessioned2024-08-15T09:26:23Z-
dc.date.available2024-08-15T09:26:23Z-
dc.date.issued2023-
dc.identifier.citationDiabetes, Obesity and Metabolism, 2023, v. 25, n. 2, p. 454-467-
dc.identifier.issn1462-8902-
dc.identifier.urihttp://hdl.handle.net/10722/345286-
dc.description.abstractAim: To evaluate the association between the number of co-morbidities, all-cause mortality and public health system expenditure in patients with type 2 diabetes (T2D) across different age groups. Materials and Methods: A retrospective observational study of T2D patients using electronic health records in Hong Kong was conducted. Patients were stratified by age (< 50, 50-64, 65-79, ≥ 80 years) and the number of co-morbidities (0, 1, 2, 3, ≥ 4), defined using the Charlson Comorbidity Index and prevalent chronic diseases identified in local surveys. The association between the number of co-morbidities, all-cause mortality and direct medical costs was examined using Cox proportional hazard regression and the gamma generalized linear model with log link function. Results: A total of 262 212 T2D patients with a median follow-up of 10 years were included. Hypertension and dyslipidaemia were the most common co-morbidities in all age groups. After age stratification, cardiovascular diseases dominated the top pair of co-morbidities in the older age groups (65-79 and ≥ 80 years), while inflammatory and liver disease were predominant among younger individuals. Compared with co-morbidity–free T2D patients, the hazard ratios (95% CI) of death for patients aged younger than 50 and 80 years or older with two co-morbidities were 1.31 (1.08-1.59) and 1.25 (1.15-1.36), respectively, and increased to 3.08 (2.25-4.21) and 1.98 (1.82-2.16), respectively, as the number of co-morbidities increased to four or more. Similar trends were observed for medical costs. Conclusions: Age-specific co-morbidity patterns were observed for patients with T2D. A greater number of co-morbidities was associated with increased mortality and healthcare costs, with stronger relationships observed among younger patients.-
dc.languageeng-
dc.relation.ispartofDiabetes, Obesity and Metabolism-
dc.subjectdatabase research diabetes complications population study primary care type 2 diabetes-
dc.titleAge-specific associations between the number of co-morbidities, all-cause mortality and public direct medical costs in patients with type 2 diabetes: A retrospective cohort study-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/dom.14889-
dc.identifier.pmid36205484-
dc.identifier.scopuseid_2-s2.0-85141381194-
dc.identifier.volume25-
dc.identifier.issue2-
dc.identifier.spage454-
dc.identifier.epage467-
dc.identifier.eissn1463-1326-
dc.identifier.isiWOS:000877543600001-

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