Cost analysis of patients diagnosed with type 2 diabetes mellitus in the endocrinological outpatient clinic of a university hospital

The aim of the study to uncover the total cost of disease in outpatients with type 2 DM and assess the impact of comorbidities and complications on costs. The study group consists of type 2 DM patients who presented to the endocrinology outpatient clinic between 01.08.2023-30.10.2023 and met the inclusion criteria. In the study, patients' comorbidities were assessed using the ACCI and complications were assessed using ICD-10 diagnosis codes with DCSI. The study sought to estimate the cost of illness of type 2 DM from a social perspective, considering direct non-medical and indirect costs from the patient's perspective and direct medical costs from the social insurance perspective. 55.6% of the study group were women, the mean age was 63.83 ± 8.93 years and the mean disease duration was 14.86 ± 7.99 years. 48.1% of patients had 5 or more comorbidities and 48.1% had ACCI scores of 5 or more. The most common DM end-organ damage was neuropathy (35.9%), followed by cardiovascular disease (30.6%) and retinopathy (29.4%). The mean DCSI score of patients was 2.52 ± 2.04, and 40.3% had a score between 1-2, while the frequency of metabolic complications according to DCSI was 57.2%. The total annual cost of type 2 DM was found to be 279,756.46 USD, and the average annual cost per person was 847.24 ± 637.17 USD. While 81.1 % of the total annual medical costs were direct medical costs, 4.5 % were direct non-medical costs and 14.4 % were indirect costs, the proportion of costs borne by the patients themselves was 12.6 %. In the multivariate linear model, age, education level, smoking of cigarettes/tobacco products, regular physical activity, medication use and complications due to hypertension and hyperlipidaemia were found to have an impact on medical costs. Considering that outpatient treatment of type 2 DM disease can place a significant economic burden on society in the study and that the items contributing most to these costs are the medications and complications within the treatment regime used, the importance of DM management becomes clear.