J Clin Outcomes Manage
Resource utilization and health care costs among diabetics with urinary tract infections in a commercially insured population
Worley K, Bell KF, Xu Y, Parasuraman S, Graham J
Abstract Objective: To evaluate resource utilization and health care costs among diabetic patients in a managed care population with both complicated and uncomplicated urinary tract infections (UTIs). Design: Retrospective cohort study using administrative health care claims. Methods: Cohort consisted of 2225 women and 756 men treated for diabetes and enrolled at least 12 months before and 6 months after the index event (UTI). Participants were individually matched on gender and age with 1 or 2 controls. Mean and median resource utilization and health care costs (all-cause and UTI-related) were examined; statistical comparisons were made for all cases vs. controls and cases with complicated vs. uncomplicated infections. Resource utilization measures included percentage hospitalized, percentage with an emergency room (ER) visit, and number of physician visits for all-cause and UTI-related services. All statistical comparisons, including those for cases with complicated vs. uncomplicated infections, were made at the nominal P value of 0.05. Results: 14.7% of women and 11.5% of men had a UTI-related ER visit, and 2.2% and 1.7% were hospitalized; the remainder were managed in an outpatient setting. Post-index median 6-month UTI-related costs were $112 (males) and $109 (females), while all-cause costs were $3446 and $3431, respectively. Mean all-cause costs for controls were significantly lower than for cases ($4478 vs. $7660 females, $4677 vs. $8011 males, both P < 0.001). Complicated infections affected less than 15% of patients, but were associated with significantly higher costs. Conclusion: UTIs among diabetics in the present study were generally uncomplicated and associated with low resource utilization and costs.
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