Diabetes cost projections raise alarm bells
Spending on healthcare can be good, but in the case of diabetes, more spending likely means worsening outcomes.
Diabetes is a prevalent and costly condition. In this essay I will put it into perspective in terms of contribution to overall health expenditures and to the entire U.S. economy. Considering the amount of money spent on diabetes, there is an opportunity for healthcare providers to assume more responsibility and receive more rewards for the care of people with diabetes.
Health Affairs recently published an article on projected healthcare expenditures through 2024. Important projections include a further shift toward government payment through Medicare and Medicaid, and an increase in the percentage of Gross Domestic Product (GDP) devoted to healthcare from
Although no disease specific projections were included, we can estimate the impact that diabetes will have on overall cost based on the American Diabetes Association Scientific Statement from 2012. In the 2012 report the estimated direct cost of diabetes care was
If we apply a 4% growth rate (consistent with the Health Affairs report) that $176 billion will have grown to over $197 billion and likely is over $200 billion for 2015. If diabetes expenses grow at the same rate as overall costs, we can expect diabetes healthcare to consume 1.2% of the GDP by 2024. This is equivalent to the percentage of GDP attributed to agriculture and fisheries.
These numbers are big enough to make us pause and think. Spending on healthcare can be good-higher expenditures on cancer care are linked to better outcomes-but in the case of diabetes, more spending likely means worsening outcomes.
More people with significant end organ involvement are suffering complications of therapy such as hypoglycemia. Approximately one-third of nursing home and residential facility days are used by people with diabetes. And diabetic patients use 43 million bed days per year in acute-care hospitals.
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