Incremental burden on health‐related quality of life, health service utilization and direct medical expenditures associated with cognitive impairment among non‐institutionalized people with diabetes aged 65 years and older
Authors' conclusion
CI was associated with worse health-related quality of life, higher health service utilization and expenditures. Our findings can be used to monitor the health and economic burden of CI in non-institutionalized older persons with diabetes.
Study context
- Population
- Non-institutionalized people with diabetes aged ≥65 years in the United States
- Participants
- 5,094 people
- Exposure
- CI vs no CI
- CIn = 804
- Outcome
- Health-related quality of life by SF-12: mental component summary score, physical component summary score and health utility
Methodological detailspropensity score weighting, Medical Expenditure Panel Surveys 2016-2019
- Propensity score weighting
- Medical Expenditure Panel Surveys 2016-2019
Main finding
As reported in the abstract
Health-related quality of life (SF-12)
Difference in mental component summary score
−8.4
P < 0.001
CI
Difference in physical component summary score
−5.2
P < 0.001
CI
Difference in health utility
−0.12
P < 0.001
CI
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Annual health service utilizationCI vs No CI | difference in ambulatory visits +4.4 | P = 0.004 |
| Annual health service utilizationCI vs No CI | difference in prescriptions +9.9 | P < 0.001 |
| Annual health service utilizationCI vs No CI | difference in probability of home care +11.3% | P < 0.001 |
| Annual health service utilizationCI vs No CI | difference in probability of ER visits +8.2% | P = 0.001 |
| Annual direct medical expendituresCI vs No CI · higher with CI | difference in total annual expenditure $5441 | P < 0.001 |
| Annual direct medical expendituresCI vs No CI · higher with CI | difference in prescription expenditure $2039 | P = 0.002 |
| Annual direct medical expendituresCI vs No CI · higher with CI | difference in home care expenditure $2695 | P < 0.001 |
| Annual direct medical expendituresCI vs No CI · higher with CI | difference in ER expenditure $118 | P < 0.001 |
Annual health service utilization
- No statistically significant difference in utilization of hospitalizations
Annual direct medical expenditures
- No statistically significant difference in expenditure of hospitalizations
Original publication
Incremental burden on health‐related quality of life, health service utilization and direct medical expenditures associated with cognitive impairment among non‐institutionalized people with diabetes aged 65 years and older. Diabetes Obes Metab. Published 3 October 2023. doi:10.
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