OBJECTIVE To estimate lifetime incremental medical spending attributed to incident type 2 diabetes (T2D) among Medicare beneficiaries by age at diagnosis, sex, and race/ethnicity. RESEARCH DESIGN AND METHODS We used the 1999–2019 100% Medicare fee-for-service claims database to identify a cohort of beneficiaries with newly diagnosed T2D in 2001–2003 using ICD codes. We matched this cohort with a nondiabetes cohort using a propensity score method and then followed the two cohorts until death, disenrollment, or the end of 2019. Lifetime medical spending for each cohort was the sum of expected annual spending, a product of actual annual spending multiplied by the annual survival rate, from the age at T2D diagnosis to death. Lifetime incremental medical spending was calculated as the difference in lifetime medical spending between the two cohorts. All spending was standardized to 2019 U.S. dollars. RESULTS Medicare beneficiaries with newly diagnosed T2D, despite having a shorter life expectancy, had 36–40% higher lifetime medical spending compared with a comparable group without diabetes. Lifetime incremental medical spending ranged from $16,115 to $122,146, depending on age at diagnosis, sex, and race/ethnicity, declining with age at diagnosis, and being highest for Asian/Pacific Islander and non-Hispanic Black beneficiaries. CONCLUSIONS The large lifetime incremental medical spending associated with incident T2D underscores the need for preventing T2D among Medicare beneficiaries. Our results could be used to estimate the potential financial benefit of T2D prevention programs both overall and among subgroups of beneficiaries.

中文翻译：

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医疗保险受益人中 2 型糖尿病事件导致的终身医疗支出：使用 1999-2019 年国家医疗保险索赔进行的纵向研究


目的 根据诊断时的年龄、性别和种族/民族，估计 Medicare 受益人中因 2 型糖尿病 (T2D) 事件导致的终生增量医疗支出。研究设计和方法 我们使用 1999-2019 年 100% 医疗保险按服务付费索赔数据库，使用 ICD 代码确定了 2001-2003 年新诊断 T2D 的一组受益人。我们使用倾向评分法将该队列与非糖尿病队列进行匹配，然后跟踪这两个队列直至死亡、退出或 2019 年底。每个队列的终生医疗支出是预期年度支出的总和，即实际年度支出的乘积乘以从 T2D 诊断时的年龄到死亡的年生存率。终生增量医疗支出计算为两个队列之间终生医疗支出的差异。所有支出均标准化为 2019 美元。结果 新诊断出的 T2D 医疗保险受益人尽管预期寿命较短，但与未患糖尿病的可比较群体相比，其终生医疗支出高出 36-40%。终生增量医疗支出从 16,115 美元到 122,146 美元不等，具体取决于诊断时的年龄、性别和种族/民族，随着诊断时的年龄而下降，亚裔/太平洋岛民和非西班牙裔黑人受益人的医疗支出最高。结论 与 T2D 事件相关的终生医疗支出大幅增加，强调了医疗保险受益人预防 T2D 的必要性。我们的结果可用于估计 T2D 预防计划的整体和受益人亚组之间的潜在经济效益。