Healthcare utilization of people with type 2 diabetes in Germany: an analysis based on health insurance data

Diabet Med. 2015 Jul;32(7):951-7. doi: 10.1111/dme.12747. Epub 2015 Mar 29.

Abstract

Aims: This population-based study assesses the healthcare utilization of people with Type 2 diabetes by analysing routine data from Allgemeine Orts-Krankenkasse (AOK), the largest statutory health insurance provider in Germany.

Methods: Anonymized billing data from all AOK-insured persons with at least one day of insurance during the evaluation year 2010 were analysed. Treatment and cost data from all areas of inpatient and outpatient care were available, as was information regarding patient age and sex. International Classification of Diseases (ICD-10) diagnosis and Anatomical Therapeutic Chemical (ATC) classification were used to identify 2.7 million insured persons with diabetes.

Results: The age- and sex-standardized prevalence of Type 2 diabetes was 9.8%. Of those patients identified, 33.9% had at least one diabetes-related complication and 83.0% had a diagnosis of hypertension. Almost two-thirds (63.1%) received antihyperglycaemic medication. Metformin and sulfonylurea were prescribed most often; medications without proof of benefit in endpoint studies were prescribed much less frequently. People without diabetes were admitted to hospital only half as often as those with Type 2 diabetes. The projected total expenditure in Germany for all people with Type 2 diabetes amounted to approximately €33.3 billion in 2010.

Conclusions: This study shows an increase in both the prevalence of diabetes and treatment costs. The majority of people with Type 2 diabetes were aged 70 years or older. One third of this group has diabetes-related complications. Antihyperglycaemic medications without proof of benefit in endpoint studies were prescribed much less frequently than drugs with proof of benefit.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Data Anonymization
  • Databases, Factual
  • Diabetes Complications / economics
  • Diabetes Complications / epidemiology
  • Diabetes Complications / therapy*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / therapy*
  • Diabetic Angiopathies / economics
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / therapy
  • Female
  • Germany / epidemiology
  • Health Care Costs
  • Humans
  • Hypertension / economics
  • Hypertension / epidemiology
  • Hypertension / therapy
  • Incidence
  • Information Storage and Retrieval
  • Insurance, Health
  • International Classification of Diseases
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Prevalence
  • Retrospective Studies