Diabetes disease progression among a Medicare Advantage population – a retrospective analysis

Diabetes disease progression among a Medicare Advantage population – a retrospective analysis

Chiguluri V, Cusano D, Prewitt T, Gopal V, Painter P, Beveridge R

 

INTRODUCTION:

Diabetes is a progressive disease which, when poorly managed, can lead to a wide range of complications including loss of vision, slow-to-heal wounds, amputations, neuropathy, peripheral vascular disease, cardiovascular, and cerebrovascular disease.   We aimed to understand the rate of progression for this population and associated impact.

METHODS:

We identified a retrospective cohort of people with diabetes without complications that was part of a national insurer’s Medicare Advantage membership during 2010 (n=167,563).  We then followed this cohort over a 3-year period to study the rate at which these members progressed to a higher severity of diabetes (i.e. diabetes with complications). 

Various outcomes were also studied, including rates of inpatient admissions, emergency room visits, and per member per month costs.  These metrics were measured across the entire cohort over time, and also measured for segments of the population that developed complications versus those that did not develop complications over time.

RESULTS:

Over a three-year period, 17% of the cohort developed complications.  This resulted in a 28% increase in medical costs, a 36% increase in inpatient admissions, and a 24% increase in emergency room visits.  In year three, the medical costs among the group with complications was double compared to the group that did not develop complications.  Inpatient admissions were 138% times higher, and emergency room visits were 68% higher.

CONCLUSION:

Slowing the progression of diabetes could significantly improve the health and well-being of people with diabetes, and may alleviate some of the costs and utilization burden on the overall healthcare system.