| Objective:Diabetes is a chronic non-communicable disease characterized by hyperglycemia caused by impaired insulin secretion or utilization.China has the largest number of people with diabetes in the world,and the long duration of diabetes and the high prevalence of complications impose a heavy economic burden on patients,their families and society.This study intends to predict the future trend of diabetes in China and estimate its economic burden,so as to provide data support for rational allocation of health care resources.Methods:In this study,the number of people with diabetes in China from 2000 to 2018published in the Global Health Data Exchange database created by the Global Burden of Disease Study was selected,and a time series was constructed using data that were natural logarithmically transformed,and an autoregressive moving average(ARIMA)model was fitted through the steps of series smoothing,model parameter estimation,and model testing.The mean absolute error(MAE),root mean square error(RMSE),mean absolute percentage error(MAPE),and coefficient of determination(~2)were used to evaluate the fitting effect of the model,and the prediction effect of the model was tested using 2019data,so as to construct the ARIMA model to predict the number of diabetes prevalence in China from 2020 to 2025.Based on the number of diabetes prevalence in 2019 published by GBD,the annual per capita treatment cost of diabetes in 2019 obtained through the health insurance system,and the number of diabetes prevalence from 2020 to 2025predicted using the ARIMA model,the product of the annual per capita treatment cost of diabetes and the number of diabetes prevalence was used to estimate the direct economic burden of diabetes from 2019 to 2025.The indirect economic burden of diabetes in 2019was estimated by multiplying 2019 GNI per capita,2019 diabetes DALYs and productivity weights for different age groups in China according to 2019 GNI per capita,2019 diabetes DALYs and productivity weights published by GBD,and the indirect economic burden of diabetes in 2019 according to the number of people with diabetes indirect economic burden per capita,and multiply the number of diabetes prevalence from 2020 to 2025 predicted by ARIMA model with the indirect economic burden per capita of diabetes in 2019 to estimate the indirect economic burden of diabetes in China from 2020 to 2025,and finally combine the direct economic burden and indirect economic burden to estimate the total economic burden of diabetes in China.Results:1.The series satisfies the condition of smooth non-white noise after the first-order difference of the time series,and the autocorrelation function(ACF)plot and partial autocorrelation function(PACF)plot are made for the series,and the values of autoregressive order and moving average order can be obtained as 2 and 1,respectively.The ARIMA(2,1,1)model was constructed,and the residuals of the ARIMA(2,1,1)model passed the white noise test(P(28)0.7669).The Mc Leod-Li test was performed,and the results showed that(P(29)0.05)and no further ARCH model was needed.The results of its RMSE(0.0092),MAE(0.0069),MAPE(0.0379),andR~2(0.998)indicated that the model fit was well,and the relative error of prediction(0.03%)showed that the model predicted well;therefore,the ARIMA(2,1,1)model was chosen to predict the prevalence trend of diabetes in China in this study.2.The overall upward trend of diabetes prevalence in China from 2000 to 2019 will continue from 2020 to 2025,and the number of diabetes prevalence in China will be about 94 million,96 million,97 million,98 million,99 million and 100million from 2020 to 2025,respectively.3.From 2019 to 2025,the direct economic burden of diabetes in China is estimated to be about 794.5 billion yuan,813.6 billion yuan,827.9billion yuan,840.3 billion yuan,850.3 billion yuan,858.2 billion yuan,and 864.2 billion yuan,respectively.The indirect economic burden of diabetes was estimated to be 283.9billion yuan,290.7 billion yuan,295.8 billion yuan,300.2 billion yuan,303.8 billion yuan,306.6 billion yuan,and 308.7 billion yuan,respectively.The total economic burden of diabetes was approximately:1078.3 billion yuan,1104.2 billion yuan,1123.7 billion yuan,11440.5 billion yuan,1154.1 billion yuan,1164.8 billion yuan,and 1172.9 billion yuan,respectively.Conclusion:The number of people with diabetes in China from 2020 to 2025 showed an increasing trend;its direct economic burden,indirect economic burden and total economic burden all showed an increasing trend;the ARIMA model achieved good results in the fitting and prediction process and was applicable to the prediction of diabetes prevalence trend in China.Therefore,it is urgent to improve the prevention and control of diabetes to regulate the increasing prevalence trend of diabetes and reduce its economic burden. |
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