The evaluation of the economic burden caused by delay in the diagnosis and treatment for patients with diabetes mellitus based on Japanese Medical Big Data_Chinese Journal of Evidence-Based Medicine

Authors：

 TANG Wentao , IWASAKI Kosuke

Milliman Inc., Tokyo, 102-0083, Japan;

Corresponding?author：

TANG Wentao, Email: twtreaher@gmail.com

Keywords：

Diabetes mellitus; Delayed diagnosis; Health care costs; Health policy; Delayed treatment; Health insurance; Japan

DOI：

10.7507/1672-2531.201808139

Video：

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Objectives To analyze the economic burden caused by delay in the diagnosis and treatment of diabetes.Methods The employee/non-employee health insurance and medical examination data from Japan Medical Data Center (JMDC) and Milliman Inc. were used to analyze the health economic burden of the situation in case the diabetic population receives timelydiagnosis and treatment with real world data.Results The overall population delaying the diabetes diagnosis and treatment in Japan was estimated to be 916 000, and the average time of delay was 39.6 months. The increase in time of delay was related with the increase in monthly medical costs after diabetes diagnosis. If the whole delayed population could receive timely diagnosis and treatment, it can totally save about 38.24 billion yuan (1.5% of the annual Japanese national medical expenditure.Conclusions The current study suggests a huge potential health economic burden that can be improved by promoting the diagnosis and treatment of diabetes, which provides reference for the economic evaluation of similar health policies and also the application of real world data in China in future.

Citation： TANG Wentao, IWASAKI Kosuke. The evaluation of the economic burden caused by delay in the diagnosis and treatment for patients with diabetes mellitus based on Japanese Medical Big Data. Chinese Journal of Evidence-Based Medicine, 2019, 19(4): 392-397. doi: 10.7507/1672-2531.201808139 Copy

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15.	International Diabetes Federation. IDF diabetes atlas - 8th edition. Available at: http://www.diabetesatlas.org/across-the-globe.html.
16.	胡善聯, 劉國恩, 許樟榮, 等. 我國糖尿病流行病學和疾病經濟負擔研究現狀. 中國衛生經濟, 2008, 27(8): 5-8.
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19.	Porta M, Curletto G, Cipullo D, et al. Estimating the delay between onset and diagnosis of type 2 diabetes from the time course of retinopathy prevalence. Diabetes Care, 2014, 37(6): 1668-1674.
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1. Wu H, Eggleston KN, Zhong J, et al. Direct medical cost of diabetes in rural China using electronic insurance claims data and diabetes management data. J Diabetes Investig, 2018, 11. In press.
2. 陳興寶, 唐玲, 陳惠云, 等. 2型糖尿病并發癥對患者治療費用的影響評估. 中國糖尿病雜志, 2003, 11(4): 238-241.
3. 日本厚生勞動省. 平成28年國民健康和營養調查. Available at: https://www.mhlw.go.jp/stf/houdou/0000177189.html.
4. Wang L, Gao P, Zhang M, et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013. JAMA, 2017, 317(24): 2515-2523.
5. 顧景范. 《中國居民營養與慢性病狀況報告(2015)》解讀. 營養學報, 2016, 38(6): 525-529.
6. 王蕊琪, 周郁秋, 賈紅紅. 糖尿病患者治療延誤行為意向的現象學研究. 護理學雜志, 2018, 3(33): 43-46.
7. Japan Medical Data Center. JMDC Claims Database的特長. Available at: https://www.jmdc.co.jp/pharma/database.html.
8. 日本厚生勞動省. 平成24年版厚生勞動白書. Available at: https://www.mhlw.go.jp/wp/hakusyo/kousei/12-2/.
9. World Health Organization. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus. Abbreviated report of a WHO consultation, 2011. Available at: http://www.who.int/diabetes/publications/report-hba1c_2011.pdf.
10. 日本糖尿病學會. 糖尿病治療指南2018～2019. Available at: http://www.jds.or.jp/modules/education/index.php?content_id=11.
11. World Health Organization. ICD-10 online versions. Available at: http://www.who.int/classifications/icd/icdonlineversions/en/.
12. WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD Index 2018. Available at: https://www.whocc.no/atc_ddd_index/.
13. 日本厚生勞動省. 平成29年版厚生勞動白書. Available at: https://www.mhlw.go.jp/wp/hakusyo/kousei/17-2/.
14. 日本厚生勞動省. 平成27年度國民醫療費的概況. Available at: https://www.mhlw.go.jp/toukei/saikin/hw/k-iryohi/15/index.html.
15. International Diabetes Federation. IDF diabetes atlas - 8th edition. Available at: http://www.diabetesatlas.org/across-the-globe.html.
16. 胡善聯, 劉國恩, 許樟榮, 等. 我國糖尿病流行病學和疾病經濟負擔研究現狀. 中國衛生經濟, 2008, 27(8): 5-8.
17. 中國政府網. 2016年我國衛生和計劃生育事業發展統計公報. Available at: http://www.nhfpc.gov.cn/guihuaxxs/s10748/201708/d82fa7141696407abb4ef764f3edf095.shtml?from=groupmessage&isappinstalled=1.
18. Harris MI, Klein R, Welborn TA, et al. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care, 1992, 15(7): 815-8199.
19. Porta M, Curletto G, Cipullo D, et al. Estimating the delay between onset and diagnosis of type 2 diabetes from the time course of retinopathy prevalence. Diabetes Care, 2014, 37(6): 1668-1674.
20. Herman WH, Ye W, Griffin SJ, et al. Early detection and treatment of type 2 diabetes reduce cardiovascular morbidity and mortality: a simulation of the results of the anglo-danish-dutch study of intensive treatment in people with screen-detected diabetes in Primary Care (ADDITION-Europe). Diabetes Care, 2015, 38(8): 1449-1455.

Chinese Journal of Evidence-Based Medicine

The evaluation of the economic burden caused by delay in the diagnosis and treatment for patients with diabetes mellitus based on Japanese Medical Big Data

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