Comorbidity and its relationship with health service use and cost in community-living older adults with diabetes: A population-based study in Ontario, Canada

Diabetes Research and Clinical Practice

Volumn 122, Issue , 2016, Pages 113-123

  Fisher, Kathryn ^a   Griffith, Lauren ^a   Gruneir, Andrea ^b   Panjwani, Dilzayn ^c   Gandhi, Sima ^d   Gafni, Amiram ^e   Chris, Patterson ^a   Markle Reid, Maureen ^a   Ploeg, Jenny ^a  

^a MCMASTER UNIVERSITY   (Canada)

^b UNIVERSITY OF ALBERTA   (Canada)

^c WOMEN S COLLEGE HOSPITAL   (Canada)

^d Lisa)   (Canada)

^e MCMASTER UNIVERSITY   (Canada)

Author keywords

Community living older adults; Comorbidity; Diabetes; Health service costs; Health service utilization; Multimorbidity

Indexed keywords

AGED; ARTHRITIS; ARTICLE; COHORT ANALYSIS; COMMUNITY LIVING; COMORBIDITY; CONSULTATION; CONTROLLED STUDY; DIABETES MELLITUS; DISEASE ASSOCIATION; EMERGENCY WARD; FEMALE; FOLLOW UP; HEALTH CARE COST; HEALTH CARE UTILIZATION; HOME CARE; HOSPITALIZATION; HUMAN; HYPERTENSION; MAJOR CLINICAL STUDY; MALE; ONTARIO; POPULATION RESEARCH; RETROSPECTIVE STUDY; VERY ELDERLY; ADULT; CLINICAL TRIAL; COMMUNITY CARE; ECONOMICS; HEALTH SERVICE; HEALTH SURVEY; MIDDLE AGED; MULTICENTER STUDY; TRENDS; UTILIZATION;

ADULT; AGED; AGED, 80 AND OVER; COMMUNITY HEALTH SERVICES; COMORBIDITY; DIABETES MELLITUS; FEMALE; FOLLOW-UP STUDIES; HEALTH CARE COSTS; HEALTH SERVICES; HUMANS; MALE; MIDDLE AGED; ONTARIO; POPULATION SURVEILLANCE; RETROSPECTIVE STUDIES;

EID: 84994713400     PISSN: 01688227     EISSN: 18728227     Source Type: Journal    
DOI: 10.1016/j.diabres.2016.10.009     Document Type: Article

References (64)

1. [1] International Diabetes Federation, IDF diabetes atlas. 6th ed., 2013, International Diabetes Federation.
2. [2] Public Health Agency of Canada. Diabetes in Canada: facts and figures from a public health perspective [Internet]; 2012. Available from: < http://www.phac-aspc.gc.ca/cd-mc/publications/diabetes-diabete/facts-figures-faits-chiffres-2011/highlights-saillants-eng.php>.
3. [3] World Health Organization. World Health Organization: diabetes fact sheet N312. [Internet]; 2015. Available from: < http://www.who.int/mediacentre/factsheets/fs312/en/>.
4. [4] Public Health Agency of Canada. Diabetes in Canada: facts and figures from a public health perspective [Internet]; 2011 [cited 2015 Aug 26]. Available from: < http://www.phac-aspc.gc.ca/cd-mc/publications/diabetes-diabete/facts-figures-caits-chiffres-2011/chap1-eng.php>.
5. [5] Young, T.K., Reading, J., Elias, B., O'Neil, J., Type 2 diabetes mellitus in Canada's First Nations: status of an epidemic in progress. Can Med Assoc J 163:5 (2000), 561–566.
6. [6] King, H., Aubert, R.E., Herman, W., Global burden of diabetes, 1995–2025 – prevalence, numerical estimates, and projections. Diabetes Care 21:9 (1998), 1414–1431.
7. [7] O'Shea, Miriam, Teeling, Mary, Bennett, K., The prevalence and ingredient cost of chronic comorbidity in the Irish elderly population with medication treated type 2 diabetes: a retrospective cross-sectional study using a national pharmacy claims database. BMC Health Serv Res, 13(23), 2013 [Internet]. Available from: < http://www.biomedcentral.com/1472-6963/13/23>.
8. [8] Maddigan, S.L., Feeny, D.H., Johnson, J.A., Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian National Population Health Survey. Qual Life Res 14 (2005), 1314–1320.
9. [9] Luijks, Hilde, Schermer, Tjard, Bor, H., et al. Prevalence and incidence density rates of chronic comorbidity in type 2 diabetes patients: an exploratory cohort study. BMC Med, 10(128), 2012 [Internet]. Available from: < http://www.biomedcentral.com/1741-7015/10/128>.
10. [10] Gijsen, R., Hoeymans, N., Schellevis, F.R., Ruwaard, D., Satariano, W.A., van den Bos, G.A.M., Causes and consequences of comorbidity: a review. J Clin Epidemiol 54 (2001), 661–674.
11. [11] Van Oostrom, S.H., Picavet, S.J., de Bruin, S.R., Stirbu, I., Korevaar, J.C., Schellevis, F.G., et al. Multimorbidity of chronic diseases and health care utilization in general practice. BMC Fam Pract, 15, 2014, 61 [Internet]. Available from: < http://www.biomedcentral.com/1471-2296/15/61>.
12. [12] Marengoni, A., Angelman, S., Melis, R., Mangialasche, F., Karp, A., Garmen, A., et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 10:4 (2011), 430–439.
13. [13] Lehnert, T., Heider, D., Leicht, H., Heinrich, S., Corrieri, S., Luppa, M., et al. Review: health care utilization and costs of elderly persons with multiple chronic conditions. Med Care Res Rev 68:4 (2011), 387–420.
14. [14] Struijs, J.N., Baan, C.A., Schellevis, F.G., Westert, G.P., van den Bos, G.A.M., Comorbidity in patients with diabetes mellitus: impact on medical health care utilization. BMC Health Serv Res, 6, 2006, 84, 10.1186/1472-6963-6-84.
15. [15] Fowler, M.J., Microvascular and macrovascular complications of diabetes. Clin Diabetes 26:2 (2008), 77–82.
16. [16] Luijks, H., Schermer, T., Bor, H., van Weel, C., Lagro-Janssen, T., Biermans, M., et al. Prevalence and incidence density rates of chronic comorbidity in type 2 diabetes patients: an exploratory cohort study. BMC Med 10:128 (2012), 1–10.
17. [17] Nolan, J.J., O'Halloran, D., McKenna, T.J., Firth, R., Redmond, S., The cost of treating type 2 diabetes (CODEIRE). Ir Med J 99:10 (2006), 307–310.
18. [18] Schmitt-Koopmann, I., Schwekglenks, M., Spinas, G.A., Szucs, T.D., Direct medical costs of type 2 diabetes and its complications in Switzerland. Eur J Public Health 14:1 (2004), 3–9.
19. [19] Simpson, S.H., Corabian, P., Jacobs, P., Johnson, J.A., The cost of major comorbidity in people with diabetes mellitus. Can Med Assoc J 168:13 (2003), 1661–1667.
20. [20] O'Brien, J.A., Caro, I., Getsios, D., Caro, J.J., Diabetes in Canada: direct medical costs of major macrovascular complications. Value Health 4:3 (2001), 258–265.
21. [21] Pagano, E., Bo, S., Petrinco, M., Rosato, R., Merletti, F., Gregori, D., Factors affecting hospitalization costs in Type 2 diabetic patients. J Diabetes Complications 23:1 (2009), 1–6.
22. [22] Goeree, R., Lim, M.E., Hopkins, R., Blackhouse, G., Tarride, J.E., Xie, F., et al. Prevalence, total and excess costs of diabetes and related complications in Ontario, Canada. Can J Diabetes 33:1 (2009), 35–45.
23. [23] Paterson, A.D., Rutledge, B.N., Cleary, P.A., Lachin, J.M., Crow, R.S., The effect of intensive diabetes treatment on resting heart rate in type 1 diabetes: the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study. Diabetes Care 30 (2007), 2107–2112.
24. [24] Hogan, P., Dall, T., Nikolav, P., Economic costs of diabetes in the US in 2002. Diabetes Care 26 (2003), 917–932.
25. [25] Pelletier, E.M., Shim, B., Ben-Joseph, R., Caro, J.J., Economic outcomes associated with microvascular complications of type 2 diabetes mellitus: results from a US claims data analysis. Pharmacoeconoimics 27:6 (2009), 479–490.
26. [26] Luijks, H., Chermer, T., Bor, H., van Weel, C., Lagro-Janssen, T., Biermans, M., et al. Prevalence and incidence density rates of chronic comorbidity in type 2 diabetes patients: an exploratory cohort study. BMC Med, 10(128), 2012 [Internet]. Available from: < http://www.biomedcentral.com/1741-7015/10/128>.
27. [27] Fakiri, F.E., Foets, M., Fijken, M., Health care use by diabetic patients in the Netherlands: patterns and predicting factors. Diabetes Res Clin Pract 61 (2003), 199–209.
28. [28] Van Dijk, C.E., Verheij, R.A., Swinkels, I.C.S., Rijken, M., Schellevis, F.G., Groenewegen, P.P., et al. What part of the total care consumed by type 2 diabetes patients is directly related to diabetes? Implications for disease management programs. Int J Integr Care 11:14 (2011), 1–10.
29. [29] Calderon-Larranaga, A., Abad-Diez, J.M., Gimeno-Feliu, L.A., Marta-Moreno, J., Gonzalez-Rubio, F., Clerencia-Sierra, M., et al. Global health care use by patients with type-2 diabetes: does the type of comorbidity matter?. Eur J Intern Med 26 (2015), 203–210.
30. [30] Valeras, J.M., Starfield, B., Sibbald, B., Salisbury, C., Roland, M., Defining comorbidity: implications for understanding health and health services. Ann Fam Med 7 (2009), 357–363.
31. [31] Pagano, E., Bo, S., Petrinco, M., Rosato, R., Merlettii, F., Gregori, D., Factors affecting hospitalization costs in Type 2 diabetic patients. J Diabetes Complications 23:1 (2009), 1–6.
32. [32] Lkhagva, D., Kuwabara, K., Matsuda, S., Gao, Y., Babazono, A., Assessing the impact of diabetes-related comorbidities and care on the hospitalization costs for patients with diabetes mellitus in Japan. J Diabetes Complications 26:2 (2012), 129–136.
33. [33] Morsanutto, A., Berto, P., Lopatriello, S., et al. Major complications have an impact on total annual medical cost of diabetes: results of a database analysis. J Diabetes Complications 20:3 (2006), 163–169.
34. [34] Huber, C.A., Diem, P., Schwenkglenks, M., Rapold, R., Reich, O., Estimating the prevalence of comorbid conditions and their effect on health care costs in patients with diabetes mellitus in Switzerland. Diabetes Metab Syndr Obes Targets Ther 7 (2014), 455–465.
35. [35] Struijs, J.M., Baas, C.A., Schellevis, F.G., Westert, G.P., van den Box, G.A., Comorbidity in patients with diabetes mellitus: impact on medical care utilization. BMC Health Serv Res, 6(1), 2006, 84.
36. [36] Gruneir, A., Markle-Reid, M., Fisher, K., Reimer, H., Ma, X., Ploeg, J., Comorbidity Burden and Health Service Use in Community-Living Older Adults with Diabetes Mellitus: A Retrospective Cohort Study. Can. J. Diabetes. 40 (2016), 35–42.
37. [37] Mercuri, M., Birch, S., Gafni, A., Using small-area variations to inform health care service planning: what do we “need” to know?. J Eval Clin Pract 19 (2013), 1054–1059.
38. [38] STROBE. STROBE statement – Strengthening the reporting of observational studies in epidemiology [Internet]; 2015 [cited 2015 Aug 28]. p. 1–2. Available from: < http://www.strobe-statement.org/index.php?id=strobe-singel-news-view&tx_ttnews%5Btt_news%5D=1467&cHash=d32ea2d69f02b2f940b412133e537268>.
39. [39] Statistics Canada. Estimates of population, by age group and sex for July 1, Canada, provinces and territories annual. [Internet]. Available from: < http://www5.statcan.gc.ca/cansim/a26?lang=eng&id=510001>.
40. [40] Statistics Canada. Statistics Canada: health problems, self-reported of person [Internet]. Definitions, data sources and methods: health problems, self-reported of person; 2015 [cited 2015 Aug 26]. Available from: < www.statcan.gc.ca/eng/concepts/definitions/health02>.
41. [41] Gruneir, A., Bell, C.M., Bronskill, S.E., Schull, M., Anderson, G.M., Rochon, P.A., Frequency and pattern of emergency department visits by long-term care residents-a population-based study. J Am Geriatr Soc 58 (2010), 510–517.
42. [42] Gruneir, A., Bronskill, S.E., Bell, C.M., et al. Recent health care transitions and emergency department use by chronic long-term care residents: a population-based cohort study. J Am Med Dir Assoc 13 (2012), 202–206.
43. [43] Rochon PA, Bronskill SE, Guneir A, Liu B, Johns A, Lo AT et al. Ontario Women's health equity report. Older women's health. Toronto, ON; 2011.
44. [44] Hux, J.E., Ivis, F., Flintoft, V., Bica, A., Diabetes in Ontario: determination of prevalence and incidence using a validated administrative data algorithm. Diabetes Care 25 (2002), 512–516.
45. [45] Vermeulen, M.J., Schull, M.J., ICD-10 adaptations of the Ontario acute myocardial infarction mortality prediction rules performed as well as the original versions. J Clin Epidemiol 60 (2007), 971–974.
46. [46] Statistics Canada. Consumer price index, health and personal care, by province (Ontario) [Internet]; 2015. Available from: < http://www.statcan.gc.ca/tableaux/sum-som/101/cst01/exon161g-eng.htm>.
47. [47] Villarroel, M.A., Vahratian, A., Ward, B., Health care utilization among U.S. adults with diagnosed diabetes. NCHS data brief. 2015, National Center for Health Statistics, Hyattsville, MD.
48. [48] Bahler, C., Huber, C.A., Brungger, B., Reich, O. Multimorbidity, Health care utilization and costs in an elderly community-dwelling population: a claims data based observational study. BMC Health Serv Res, 15(23), 2015.
49. [49] Du, Y., Heidemann, C., GoBwald, A., Schmich, P., Scheidt-Nave, C., Prevalence and comorbidity of diabetes mellitus among non-institutionalized older adults in Germany – results of the national telephone health interview survey “German Health Update (GEDA)” 2009. BMC Public Health, 13(1), 2013, 166.
50. [50] Schett, G., Kleyer, A., Perricone, C., et al. Diabetes is an independent predictor for severe osteoarthritis: results from a longitudinal cohort study. Diabetes Care 36:2 (2013), 403–409.
51. [51] Lipscombe, L.L., Booth, G.L., Jamal, S.A., Hawker, G.A., The risk of hip fractures in older individuals with diabetes – a population-based study. Diabetes Care 30:4 (2007), 835–841.
52. [52] Jung, J.K., Kim, H.J., Lee, H.K., Sim, S.S., Chan, S., Kim, J.T., Fracture incidence and risk of osteoporosis in female type 2 diabetic patients in Korea. Diabetes Metab J 36:2 (2012), 144–150.
53. [53] Magnan, Elizabeth M., Palta, Mari, Johnson, Heather M., Bartels, C.M., Schumacher, J.R., Smith, M.A., The impact of a patient's concordant and discordant chronic conditions on diabetes care quality measures. J Diabetes Complications 29 (2015), 288–294.
54. [54] Piette, J.D., Kerr, E.A., The impact of comorbid chronic conditions on diabetes care. Diabetes Care 29:3 (2006), 725–731.
55. [55] Gudala, K., Bansal, D., Shlifano, F., Bhansali, A., Diabetes mellitus and risk of dementia: a meta-analysis of prospective observational studies. J Diabetes Investig 4:6 (2013), 640–650.
56. [56] Iron, K., Lu, H., Manuel, D., Henry, D., Gershon, A., Using linked health administrative data to assess the clinical and healthcare system impact of chronic diseases in Ontario. Healthc Q 14 (2011), 23–27.
57. [57] Lix, L.M., Quali, J., Fadahunsi, O., Teare, G.F., Predictive performance of comorbidity measures in administrative databases for diabetes cohorts. BMC Health Serv Res, 13(1), 2013, 340.
58. [58] Starfield, B., Lemke, K.W., Bernhardt, T., Foldes, S.S., Forrest, C.B., Weiner, J.P., Comorbidity: implications for the Importance of Primary Care in “Case” Management. Ann Fam Med 1:1 (2003), 8–14.
59. [59] Van Dijk, C.E., Hoekstra, T., Verheij, R.A., Tweisk, J.W.R., Groenewegen, P.P., Schellevis, F.G., et al. Type II diabetes patients in primary care: profiles of healthcare utilization obtained from observational data. BMC Health Serv Res, 13(7), 2013 [Internet]. Available from: < http://www.biomedcentral.com/1472-6963/13/7>.
60. [60] Laiteerapong, N., Huang, E.S.C.M., Prioritization of care in adults with diabetes and comorbidity. Ann N Y Acad Sci 1243 (2011), 69–87.
61. [61] Morris, R.L., Sanders, C., Kennedy, A.P.R.A., Shifting priorities in multimorbidity: a longitudinal qualitative study of patient's prioritization of multiple conditions. Chronic Illn 7:2 (2011), 147–161.
62. [62] Fortin, M., Contant, E., Savard, C., Hudon, C., Poitras, M.E.A.J., Canadian guidelines for clinical practice: an analysis of their quality and relevance to the care of adults with comorbidity. BMC Fam Pract, 12(1), 2011, 74.
63. [63] Yoon, J., Zulman, D., Scott, J., Maciejewski, M., Costs associated with multimorbidity among VA patients. Med Care Res Rev 52:3, Suppl. 2 (2014), S31–6.
64. [64] Magnan, E.M., Palta, M., Johnson, H.M., Bartels, C.M., Schumacher, J.R., Smith, M., The impact of a patient's concordant and discordant chronic conditions on diabetes care quality measures. J Diabetes Complications 29 (2015), 288–294.