Disease Burden Asscoiated With Chronic Complications Of Type 2 Diabetes Mellitus

Health is an inevitable requirement for promoting the comprehensive development of human beings,is a basic condition for economic and social development,and is an important symbol of national prosperity and prosperity.The "Healthy China 2030" Planning Outline sets out the goals of "implementing a comprehensive prevention and control strategy for chronic diseases" and "to comprehensively promote the reform of the medical insurance payment method".Among all chronic diseases,diabetes is the third largest chronic disease in the world,only next to cardiovascular diseases and cancer.And many chronic complications caused by diabetes will further reduce the patient’s life expectancy and quality of life,and increase the patient’s economic burden.Under the conditions of limited medical and health resources,how to determine the focus and direction of diabetes prevention and control,make reasonable health decisions,how to formulate more scientific diabetes-related payment methods,and improve the utilization efficiency of medical insurance funds have become the problems to be solved urgently.In carrying out disease burden research,unified indicators can be used to objectively and quantitatively evaluate different diseases under the same standard,so as to make scientific disease prevention and control decisions for the health department and provide data support for the medical insurance department to further deepen the reform of payment methods.This study is based on a 30% random sampling database of Tianjin urban employee basic medical insurance insurers from 2008 to 2015 to quantitatively compare the type2 diabetes patients in China,especially the newly diagnosed type 2 diabetes patients with cardiovascular disease,cerebrovascular disease,peripheral blood vessels The disease burden of diseases,podiatry,nephropathy,retinopathy and neuropathy,including the incidence of different chronic complications(including incidence density and cumulative incidence),and the direct medical costs associated with different chronic complications,with particular attention to differ the net effect of chronic complications on the average annual medical costs.The results showed that among chronic complications,the incidence density(316.6/1000 person-years)and cumulative incidence(the cumulative incidence in the seventh year was 80.8%)of nephropathy were the highest,followed by neuropathy(257.7/1000 person-years,the cumulative incidence in the seventh year is 75.7%).In terms of direct medical costs,foot disease related hospitalization costs is the highest(RMB 25,825),followed by peripheral vascular disease(RMB 20,797);compared with patients without any new complications,cardiovascular disease and cerebrovascular diseases,especially myocardial infarction and stroke had the largest net impact on first quarterly costs,at 9.4 times and 5.2 times,respectively.Therefore,this study suggests that we can consider the grading management of the prevention and treatment of chronic complications of diabetes in order to better manage patients;actively explore the diabetes capitation and diagnosis related group policy and formulate more reasonable payment standards to achieve scientific management and control of medical insurance funds;pay special attention to the prevention and control of chronic complications in newly diagnosed type 2 diabetes patients,and achieve comprehensive prevention and treatment of diabetes and its chronic complications;make full use of medical and health big data to provide data support for policy.