Health care service use and costs for a cohort of high-needs elderly diabetic patients

Published: April 1, 2021
Category: Bibliography
Authors: Alessandro Buja, Carlo Pinato, Giulia Grotto, Ricardo Caberlotto, Roberto Toffanin, Simona Fortunata Mafrici, Stefano Rigon, Tatjana Baldovin, Umberto Bolzonella, Vincenzo Baldo
Countries: Italy
Language: English
Types: chronic condition, Finance/Budgeting, Population Health, Utilization
Settings: Government



To describe the impact of diabetes comorbidities on the health care services use and costs of a cohort of elderly patients with diabetes and high health care needs (HHCN), based on real-world data.


We focused on a cohort of diabetic patients with HHCN belonging to Resource Utilization Bands 4 and 5 according to the Adjusted Clinical Group (ACG) system. Their comorbidities were assessed using the clinical diagnoses that the ACG system assigns to single patients by combining different information flows. Regression models were applied to analyze the associations between comorbidities and health care service use or costs, adjusting for age and sex.


Our analyses showed that all health care service usage measures (e.g. access to emergency care; number of outpatient visits) and the total annual costs and pharmacy costs are associated significantly with comorbidity class. Instead, no differences in hospitalization rates by comorbidity class were revealed.


The association between a larger number of comorbidities and higher total health care service usage and costs was seen mainly for primary care services. This underscores the need to strengthen primary care for today’s aging and multimorbid population.

Diabetes comorbidities,Health care service use,Health care service costs

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