Differences in activity from Hospital Episode Statistics (HES) for patients with Type 2 diabetes and patients without diabetes linked at GP Practice level (GPP) to levels of glycaemic control as measured by glycated haemoglobin (HbA1c) taken from National Diabetes Audit (NDA) allowing for age, social deprivation, gender and ethnicity of both populations

Stedman, M; Heald, A; Davies, M; Fryer, A; Lunt, M; Livingstone, M; Gadsby, R; Moreno, G; Andersen, S

Abstract

Aims: To compare associated hospital activity between patients with Type 2 diabetes and patients without diabetes and consider the impact of differing levels of glycaemic control on this difference, allowing for variation in local demographics.

Method: HES data for individuals with Type 2 diabetes (identified by diagnostic code) and individuals without diabetes, for non-elective and elective costs, admissions and length of stay were aggregated by their GPP in 2016–17and 2017–18. This was linked to total patient numbers and characteristics including HbA1c data from NDA in 2014–15, 2015–16 and 2016–17.

Multivariate regression was used to evaluate the differences between population without diabetes and population with Type 2 diabetes. HbA1c groups were included to evaluate impact of different levels of glycaemic control.

Results: 2.4 million patients with Type 2 diabetes were identified in the process (out of 2.8 million total/6.5% of population). These incurred total of £1.9 billion non-elective and £1.4 billion elective costs out of a total £19 billion/17% admission costs. Diabetes non-elective were 24% and elective 14% of total costs. Equivalent demographic population without diabetes would be £0.5 billion non-elective and £0.7 billion elective, so the additional cost of diabetes including overall healthcare impacts in secondary care is £1.4 billion non-elective and £0.6 billion elective. Links to levels of HbA1c control achieved indicate that 45% of this difference in non-elective and 25% in elective admissions could be mitigated by improving glycaemic control.

Conclusion: Investment in medication and other measures to improve glycaemia in Type 2 diabetes is increasing. This is the first study that manages to capture the impact of Type 2 diabetes on healthcare costs and then try to quantify the reduction in associated longer term healthcare costs from this investment.

Citation

Stedman, M., Heald, A., Davies, M., Fryer, A., Lunt, M., Livingstone, M., …Andersen, S. (2019, March). Differences in activity from Hospital Episode Statistics (HES) for patients with Type 2 diabetes and patients without diabetes linked at GP Practice level (GPP) to levels of glycaemic control as measured by glycated haemoglobin (HbA1c) taken from National Diabetes Audit (NDA) allowing for age, social deprivation, gender and ethnicity of both populations. Paper presented at Diabetes UK Professional Conference 2019, ACC Liverpool, Liverpool, UK

• Presentation Conference Type: Conference Paper (unpublished)
• Conference Name: Diabetes UK Professional Conference 2019
• Conference Location: ACC Liverpool, Liverpool, UK
• Start Date: Mar 6, 2019
• End Date: Mar 8, 2019
• Deposit Date: Jun 21, 2023