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Cost of cardiovascular disease events in patients with and without type 2 diabetes and factors inluencing cost: a retrospective cohort study

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Abstract
Background Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) are non-communicable diseases
that impose a signiicant economic burden on healthcare systems, particularly in low- and middle-income countries.
The purpose of this study was to evaluate the hospital treatment cost for cardiovascular disease events (CVDEs)
in patients with and without diabetes and identify factors inluencing cost.
Method We conducted a retrospective, cross-sectional study using administrative data from three public tertiary
hospitals in Malaysia. Data for hospital admissions between 1 March 2019 and 1 March 2020 with International
Classiication of Diseases 10th Revision (ICD-10) codes for acute myocardial infarction (MI), ischaemic heart disease (IHD),
hypertensive
heart
disease,
stroke,
heart
failure,
cardiomyopathy,
and
peripheral vascular disease
(PVD)

were
retrieved
from
the
Malaysian Disease
Related
Group
(Malaysian
DRG)
Casemix
System.
Patients
were
stratiied

by
T2DM status
for
analyses.
Multivariate
logistic
regression
was
used
to
identify
factors inluencing
treatment
costs.
Results Of the 1,183 patients in our study cohort, approximately 60.4% had T2DM. The most common CVDE
was acute MI (25.6%), followed by IHD (25.3%), hypertensive heart disease (18.9%), stroke (12.9%), heart failure (9.4%),
cardiomyopathy (5.7%) and PVD (2.1%). Nearly two-thirds (62.4%) of the patients had at least one cardiovascular
risk factor, with hypertension being the most prevalent (60.4%). The treatment cost for all CVDEs was RM 4.8 million
and RM 3.7 million in the T2DM and non-T2DM group, respectively. IHD incurred the largest cost in both groups,
constituting 30.0% and 50.0% of the total CVDE treatment cost for patients with and without T2DM, respectively.
Predictors of high treatment cost included male gender, non-minority ethnicity, IHD diagnosis and moderate-to-high
severity level.
Conclusion This study provides real-world cost estimates for CVDE hospitalisation and quantiies the combined
burden of two major non-communicable disease categories at the public health provider level. Our results conirm
that CVDs are associated with substantial health utilisation in both T2DM and non-T2DM patients.
Keywords Cardiovascular disease, Cardiovascular disease event, Type 2 diabetes mellitus, Hospitalisation, Treatment
cost, Casemix, Diagnosis Related Group

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Judul Seri

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No. Panggil

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Penerbit

: .,

Deskripsi Fisik

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Bahasa

Indonesia

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Klasifikasi

NONE

Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

JURNAL

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Pernyataan Tanggungjawab

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