Chronic Disease Cost Calculator (Diabetes)

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Introduction

Diabetes is a chronic condition when the human body cannot produce insulin or use an existing one. As a rule, this term refers to the general name of a group of endocrine diseases. Therefore, all ailments of this “set” have a common symptom: polyuria (increased urine formation). Still, only diabetes mellitus is associated with an increase in the concentration of glucose in the blood. Currently, it is known that more than 37 million Americans (about 11%) live with diabetes of any type, and 32.8% of the US population will live with the condition by 2050 (Remington et al., 2016). Such a disappointing picture of the situation is a new harsh reality. The fight against diabetes is a fundamental and achievable goal for residents of a particular territory and for all humankind from different parts of the world. A deep and comprehensive analysis of the problem within the framework of financial aspects is the key to success in realizing the health of nations. This paper aims at a thorough, detailed, and exhaustive explanation of such a chronic disease as diabetes in terms of the prevalence and cost of treatment in the United States and Maryland.

Interesting Facts

Primarily, one should emphasize that diabetes is one of the most common disorders in the United States, the treatment of which, for some citizens, costs a lot of finances. Undiagnosed symptoms of the disease in time or the lack of proper interventions can lead to complications such as stroke, heart and kidney diseases, amputations, and even death (Bhopal, 2019). Thus, according to Remington, Brownson, and Wegner (2016), about 3% of all casualties in the country are attributable to this chronic health condition. Over a hundred thousand people of all ages, races, or nationalities in America and worldwide die each year due to diabetes or complications directly related to the disease, and this circumstance poses a severe threat to the population of the globe.

Vulnerable Population

As practice shows, older people, representatives of specific races and nations, minority groups, low-income individuals, and some other categories of people are at the most significant risk of developing diabetes. Among the most common causes of type 1 diabetes, viral infections, lack of breastfeeding, and genetic factors should be highlighted. Accordingly, prevalent factors that can stimulate the development of type 2 diabetes include genetic predisposition, age, and ethnicity (for example. Asians, Hispanics, and Africans are at greater risk than other groups), as well as people with overweight or impaired carbohydrate metabolism.

Modifiable Behaviors

Several major risk factors for type 1 and type 2 diabetes can be influenced to reduce the likelihood of the disease. They include overweight, incorrect and unhealthy diet, insufficient physical activity, smoking and alcohol consumption, sleep disorders, stress, and concomitant diseases such as arterial hypertension, atherosclerosis, disorders of fat metabolism, polycystic ovaries, and others. For example, addressing obesity across an individual’s lifespan and not just in adulthood can help avert the onset of diabetes. Overweight people have a higher chance of getting diabetes, and that risk increases as one gains more weight. Obesity arises from several unhealthy lifestyle factors, such as consuming vast amounts of sugary and junk foods.

Diabetes Prevalence in Maryland

Table 1: Diabetes Prevalence in Maryland

Sex	Age Group (in years)	Estimated Cases (in thousands)	Rate (per 100)	95% Confidence Interval
Sex	Age Group (in years)	Estimated Cases (in thousands)	Rate (per 100)	Lower Limit	Upper Limit
Overall	18-44	3,325	2.9	2.8	3.1
	45-64	11,482	13.7	13.3	14.0
	65-74	5,822	22.7	22.1	23.3
	75+	4,222	21.6	20.9	22.3
	Total	24,851	10.2	10.0	10.4
Males	18-44	1,535	2.7	2.4	2.9
	45-64	5,963	14.6	14.0	15.1
	65-74	2,958	24.7	23.8	25.7
	75+	1,861	24.0	22.7	25.2
	Total	12,317	10.4	10.2	10.7
Females	18-44	1,790	3.2	2.9	3.4
	45-64	5,520	12.8	12.4	13.3
	65-74	2,864	21.0	20.1	21.8
	75+	2,361	20.1	19.2	21.0
	Total	12,534	10.0	9.8	10.3

According to the Centers for Disease Control (CDC) data, diabetes prevalence in the state of Maryland is slightly lower than the national average. Overall, the majority stands at 10.2 percent, compared with a national average of 11.7 percent. Further, the same data reveals that diabetes prevalence in Maryland is higher in men than in women, varying by a point four percent. Moreover, when assessed by age, diabetes prevalence is lowest for people aged between 18 years and 44 years.

Costs – Economic Burden

Table 2: Diabetes Economic Burden

All Payers
	Population	% Treated	Treated population	Cost per person	Total costs
US overall	304,059,724	6.70%	20,311,500	$6,320	$128,352
Maryland	5,633,597	7,20%	405,500	$5,870	$2,378
Medicaid
	MCD population	% Treated	MCD treated population	Cost per person	Total costs
US overall	58,238,773	7.20%	4,200,300	$4,470	$18,761
Maryland	757,031	7.60%	57,200	$4,270	$244
Medicare
	MCR population	% Treated	MCR treated population	Cost per person	Total costs
US overall	44,831,390	20.20%	9,063,200	$3,910	$35,440
Maryland	740,811	22.50%	166,600	$3,740	$623
Private insurers
	PRV population	% Treated	PRV treated population	Cost per person	Total costs
US overall	202,468,416	6.00%	12,215,200	$2,920	$35,676
Maryland	4,241,261	6.60%	278,900	$2,800	$782

The analysis of information from the Cost of Healthcare Calculator revealed that the cost of treatment and management of diabetes varies depending on the insurance used by a patient. Thus, for instance, the price per person in the United States and Maryland using the all-payer system is $6,320 and 5,870. Therefore, the treatment of diabetes in an individual using the Medicaid program will be between $4,470 and $4,270, and in the case of operating with Medicaid, this amount will be in the region of $3,910 and $3,940. Finally, diabetes costs per person when a patient uses private insurance in the United States and Maryland are $2,290 and 2,800, respectively. The total cost for each category is calculated by multiplying the price per patient with the number of people treated during the year in millions of dollars. In this case, the $18,209 cost is the approximate total amount for all services per citizen by summing the taxpayers. This figure allows one to estimate the expenses not only at an individual level but also at the population.

As a rule, these calculations and operations occur within the framework of direct and indirect costs. Additionally, direct costs are expenses attributed to certain medical services provided without additional estimates; in other words, they are associated with producing specific types of assistance. Consequently, indirect costs are payments that cannot instantly be attributed to particular services and are assigned to medical assistance expenses through calculated coefficients. Moreover, indirect costs are associated with producing several varieties of services and usually relate to an entire institution or its divisions.

Absenteeism Costs

Table 3: Diabetes Absenteeism

	Population	% Treated	Treated population	% Employed	Employed treated population	Missed days/ employed person	Total missed days	Daily wage	Total absenteeism
US overall	304,059,724	6.70%	20,311,500	46,00%	9,340,600	2	18,844,000	$250	$4,711
Maryland	5,633,597	7.20%	405,500	46,40%	188,300	2	384,00	$247	$95

Absenteeism is the cost of workdays lost due to diabetes ailment. It is calculated by estimating the number of workdays lost due to diabetes and valuing them using national age-group and sex-specific earnings adjusted to the state level using a state-to-national adjustment factor. Absenteeism costs are an indirect cost accrued due to diabetes. An indirect cost is an expense incurred due to a cessation of work or reduced productivity due to illness. From an analysis of the Cost of Calculator data provided, the total absenteeism costs in the United States and the state of Maryland are 4.711 billion and 95 billion, respectively. In addition, the data shows that people in the US and Maryland miss two days due to diabetes, with the average wages for missed days estimated at $250 and $247.

Diabetes Costs Projections

Table 4: Diabetes Costs Projections

All Diseases Projections (US Overall)
Year	Diabetes
2010	$141,188
2011	$148,697
2012	$157,323
2013	$166,267
2014	$175,664
2015	$185,734
2016	$196,148
2017	$207,089
2018	$218,605
2019	$230,766
2020	$243,832
% increase 2010-2020	72.70%

The data provided by the Cost of Healthcare Calculator shows that the cost of diabetes in the United States was $141.188 billion in 2010. Further, data projections show that diabetes will cost the United States $243.832 billion in 2020. This amount has not been adjusted for inflation and represents a 72.70 percent increase in the cost of treatment and management of diabetes in the United States. The total costs and their projections are calculated by adding direct costs and indirect costs associated with diabetes in the US. However, a breakdown of this data to state-level cost projection was not provided in the Cost of Healthcare data.

Nonetheless, there are some limitations, difficulties, and obstacles in determining reliable and objective information. It should be remembered that the presented details give a person a brief and superficial look at the costs of diabetes to assess the situation and draw certain conclusions. The lack of accurate and reliable data from the point of view of quantitative research, the limited sample size, and shortcomings, in fact, measurement methods, are among the few limitations that prevented the competent and correct establishment of expense forecasts. Moreover, data at the Maryland state level with the USA are compared based on total, direct, and indirect costs, taking into account a specific time interval.

Conclusion

From the discussions in this paper, it is apparent that diabetes adds an unacceptably high financial burden on individuals and society in Maryland and the US. Besides the obvious medical costs of treating diabetes, other indirect costs, such as absenteeism, negatively impact individuals and society alike. This financial burden brought about by a condition that is mainly preventable impacts the economic well-being of many families in the United States, specifically in the state of Maryland. In general, there is a slight prevalence of diabetes in Maryland, unlike in other regions; most often, this chronic condition in this state is observed in men aged 44 years and older. The Cost of Calculator data shows that diabetes treatment in Maryland is lower than the average cost of medicine in the US. However, the cost of diabetes treatment will depend on what kind of insurance a person has. Moreover, absenteeism cost is similar, while the overall costs of treating and managing diabetes in the US are projected to increase by 72.70%.

Recommendations

Most of the population in the US and Maryland, in particular, should have comprehensive and adequate health insurance coverage to mitigate against the financial burden caused by diabetes. Additionally, there should be active efforts to bring down direct and indirect costs of diabetes in Maryland and the US. Finally, the state of Maryland should have a comprehensive health policy that details its strategy for preventing diabetes prevalence and incidence.

References

Bellou, V., Belbasis, L., Tzoulaki, I., & Evangelou, E. (2018). Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of Meta-analyses.PLOS ONE, 13(3). Web.

Bhopal, R. S. (2019). Other risk factors and explanations.Epidemic of Cardiovascular Disease and Diabetes, 173–197. Web.

CDC. (2022). Diabetes states burden-Maryland. Web.

Linder, S., Marko, D., Tian, Y., & Wisniewski, T. (2018). A population-based approach to mapping vulnerability to diabetes. International Journal of Environmental Research and Public Health, 15(10), 21–67. Web.

Remington, P.L., Brownson. R.C., & Wegner. M.V. (2016). Chronic disease epidemiology, prevention and control (4^th ed.). Alpha Press.

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