From: The high-cost, type 2 diabetes mellitus patient: an analysis of managed care administrative data
Cohort | ||||||||
---|---|---|---|---|---|---|---|---|
Top 10% of costs | Bottom 90% of costs | Top 20% of costs | Bottom 80% of costs | |||||
N | % | N | % | N | % | N | % | |
Total sample | 172,004 | 1,548,037 | 344,019 | 1,376,022 | ||||
Age (years) | ||||||||
< 18 | 1,194 | 0.69% | 17,232 | 1.11% | 3,469 | 1.01% | 14,957 | 1.09% |
18-25 | 1,445 | 0.84% | 17,163 | 1.11% | 3,269 | 0.95% | 15,339 | 1.11% |
25-34 | 4,920 | 2.86% | 56,918 | 3.68% | 11,866 | 3.45% | 49,972 | 3.63% |
35-44 | 14,922 | 8.68% | 164,584 | 10.63% | 31,878 | 9.27% | 147,628 | 10.73% |
45-54 | 40,506 | 23.55% | 359,704 | 23.24% | 80,397 | 23.37% | 319,813 | 23.24% |
55-64 | 69,775 | 40.57% | 474,253 | 30.64% | 130,935 | 38.06% | 413,093 | 30.02% |
≥ 65 | 39,168 | 22.77% | 457,026 | 29.52% | 82,028 | 23.84% | 414,166 | 30.10% |
Missing/unknown | 74 | 0.04% | 1,157 | 0.07% | 177 | 0.05% | 1,054 | 0.08% |
Mean (SD) | 57.46 | (12.89) | 57.61 | (14.82) | 57.17 | (13.66) | 57.7 | (14.87) |
Sex | ||||||||
Male | 86,359 | 50.21% | 789,524 | 51% | 164,587 | 47.84% | 711,296 | 51.69% |
Female | 85,630 | 49.78% | 758,425 | 48.99% | 179,402 | 52.15% | 664,653 | 48.30% |
Missing/unknown | 15 | 0.01% | 88 | 0.01% | 30 | 0.01% | 73 | 0.01% |
Geographic region | ||||||||
East | 55,618 | 32.34% | 521,500 | 33.69% | 113,485 | 32.99% | 463,633 | 33.69% |
South | 36,130 | 21.01% | 371,487 | 24% | 71,733 | 20.85% | 335,884 | 24.41% |
Midwest | 55,462 | 32.24% | 444,249 | 28.70% | 110,809 | 32.21% | 388,902 | 28.26% |
West | 24,794 | 14.41% | 210,801 | 13.62% | 47,992 | 13.95% | 187,603 | 13.63% |
Health plan type | ||||||||
Health maintenance organization | 37,332 | 21.70% | 293,868 | 18.98% | 73,580 | 21.39% | 257,620 | 18.72% |
Preferred provider organization | 96,019 | 55.82% | 873,018 | 56.40% | 190,440 | 55.36% | 778,597 | 56.58% |
Point of service | 23,776 | 13.82% | 178,510 | 11.53% | 45,378 | 13.19% | 156,908 | 11.40% |
Indemnity | 13,218 | 7.68% | 181,335 | 11.71% | 31,063 | 9.03% | 163,490 | 11.88% |
Missing/unknown | 1,659 | 0.96% | 21,306 | 1.38% | 3,558 | 1.03% | 19,407 | 1.41% |
Payer type | ||||||||
Commercial | 125,980 | 73.24% | 1,156,587 | 74.71% | 253,795 | 73.77% | 1,028,772 | 74.76% |
Medicaid | 3,154 | 1.83% | 17,382 | 1.12% | 6,019 | 1.75% | 14,517 | 1.05% |
Medicare | 18,213 | 10.59% | 91,170 | 5.89% | 31,044 | 9.02% | 78,339 | 5.69% |
Self | 19,946 | 11.60% | 213,595 | 13.80% | 42,432 | 12.33% | 191,109 | 13.89% |
Medicare Gap | 3,987 | 2.32% | 60,944 | 3.94% | 9,317 | 2.71% | 55,614 | 4.04% |
Missing/unknown | 724 | 0.42% | 8,359 | 0.54% | 1,412 | 0.41% | 7,671 | 0.56% |
CCI Scorea | ||||||||
Mean (SD) | 4.27 (3.04) | 2.07 (1.68) | 3.66 (2.75) | 1.95 (1.55) | ||||
CCI < 2 | 32,217 | 18.73% | 879,610 | 56.82% | 88,195 | 25.64% | 823,632 | 59.86 |
CCI ≥ 2 | 139,787 | 81.27% | 668,427 | 43.18% | 255,824 | 74.36% | 552,390 | 40.14 |
Charlson comorbidities | ||||||||
Myocardial infarction | 20,594 | 11.97% | 32,411 | 2.09% | 29,040 | 8.44% | 23,965 | 1.74% |
Congestive heart failure | 36,022 | 20.94% | 84,121 | 5.43% | 55,756 | 16.21% | 64,387 | 4.68% |
Peripheral vascular disease | 21,069 | 12.25% | 68,687 | 4.44% | 34,510 | 10.03% | 55,246 | 4.01% |
Cardiovascular disease | 31,358 | 18.23% | 109,220 | 7.06% | 53,770 | 15.63% | 86,808 | 6.31% |
Dementia | 2,419 | 1.41% | 11,390 | 0.74% | 4,765 | 1.39% | 9,044 | 0.66% |
Chronic pulmonary disease | 49,776 | 28.94% | 213,749 | 13.81% | 89,955 | 26.15% | 173,570 | 12.61% |
Rheumatological disease | 8,821 | 5.13% | 30,566 | 1.97% | 15,119 | 4.39% | 24,268 | 1.76% |
Peptic ulcer disease | 5,174 | 3.01% | 13,678 | 0.88% | 8,643 | 2.51% | 10,209 | 0.74% |
Mild liver disease | 3,654 | 2.12% | 6,305 | 0.41% | 5,380 | 1.56% | 4,579 | 0.33% |
Diabetes without chronic complications | 169,829 | 98.74% | 1,525,023 | 98.51% | 339,677 | 98.74% | 1,355,175 | 98.48% |
Diabetes with chronic complications | 45,140 | 26.24% | 219,433 | 14.17% | 83,992 | 24.41% | 180,581 | 13.12% |
Paraplegia | 3,765 | 2.19% | 4,538 | 0.29% | 5,139 | 1.49% | 3,164 | 0.23% |
Renal impairment | 17,789 | 10.34% | 29,344 | 1.90% | 26,180 | 7.61% | 20,953 | 1.52% |
Cancer | 34,466 | 20.04% | 101,118 | 6.53% | 54,085 | 15.72% | 81,499 | 5.92% |
Severe liver disease | 39,130 | 22.75% | 113,367 | 7.32% | 66,117 | 19.22% | 86,380 | 6.28% |
Metastatic cancer | 9,830 | 5.71% | 7,726 | 0.50% | 12,346 | 3.59% | 5,210 | 0.38% |
HIV/AIDS | 1,094 | 0.64% | 2,050 | 0.13% | 1,693 | 0.49% | 1,451 | 0.11% |
Antidiabetic agents received on Index | ||||||||
Glucagon-like peptide-1 | 991 | 0.58% | 7,500 | 0.48% | 2,390 | 0.69% | 6,101 | 0.44% |
Dipeptidyl peptidase-4 | 629 | 0.37% | 6,071 | 0.39% | 1,291 | 0.38% | 5,409 | 0.39% |
Biguanides | 21,285 | 12.37% | 218,752 | 14.13% | 46,060 | 13.39% | 193,977 | 14.10% |
Sulfonylureas | 14,169 | 8.24% | 122,570 | 7.92% | 29,290 | 8.51% | 107,449 | 7.81% |
Thiazolidinedione | 9,976 | 5.80% | 85,809 | 5.54% | 23,079 | 6.71% | 72,706 | 5.28% |
Meglitinides | 1,045 | 0.61% | 7,266 | 0.47% | 2,491 | 0.72% | 5,820 | 0.42% |
Alpha-glucosidase inhibitors | 187 | 0.11% | 1,435 | 0.09% | 460 | 0.13% | 1,162 | 0.08% |
Insulin | 14,220 | 8.27% | 70,542 | 4.56% | 29,921 | 8.70% | 54,841 | 3.99% |
Other antidiabetic agents | 8,689 | 5.05% | 79,749 | 5.15% | 19,045 | 5.54% | 69,393 | 5.04% |