Identifying and delineating the type 2 diabetes population in the Netherlands using an all-payer claims database: characteristics, healthcare utilisation and expenditures
Objectives We aimed to identify and delineate the Dutch type 2 diabetes population and the distribution of healthcare utilisation and expenditures across the health system from 2016 to 2018 using an all-payer claims database.Design Retrospective observational cohort study based on an all-payer claim...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021-12-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/12/e049487.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846129322003267584 |
|---|---|
| author | Dirk Ruwaard Henk J G Bilo Rose J Geurten Arianne M J Elissen Jeroen N Struijs Chantal van Tilburg |
| author_facet | Dirk Ruwaard Henk J G Bilo Rose J Geurten Arianne M J Elissen Jeroen N Struijs Chantal van Tilburg |
| author_sort | Dirk Ruwaard |
| collection | DOAJ |
| description | Objectives We aimed to identify and delineate the Dutch type 2 diabetes population and the distribution of healthcare utilisation and expenditures across the health system from 2016 to 2018 using an all-payer claims database.Design Retrospective observational cohort study based on an all-payer claims database of the Dutch population.Setting The Netherlands.Participants The whole Dutch type 2 diabetes population (n=900 522 in 2018), determined based on bundled payment codes for integrated diabetes care and medication use indicating type 2 diabetes.Outcome measures Annual prevalence of type 2 diabetes, comorbidities and characteristics of the type 2 diabetes population, as well as the distribution of healthcare utilisation and expenditures were analysed descriptively.Results In 2018, 900 522 people (6.5% of adults) were identified as having type 2 diabetes. The most common comorbidity in the population was heart disease (12.1%). Additionally, 16.2% and 5.6% of patients received specialised care for microvascular and macrovascular diabetes-related complications, respectively. Most patients with type 2 diabetes received pharmaceutical care (99.1%), medical specialist care (97.0%) and general practitioner consultations (90.5%). In total, €8173 million, 9.4% of total healthcare expenditures, was reimbursed for the type 2 diabetes population. Medical specialist care accounted for the largest share of spending (38.1%), followed by district nursing (12.4%), and pharmaceutical care (11.5%).Conclusions All-payer claims databases can be used to delineate healthcare use: this insight can inform health policy and practice and, thereby, support better decisions to promote long-term sustainability of healthcare systems. The healthcare utilisation of the Dutch type 2 diabetes population is distributed across the health system and utilisation of medical specialist care is high. This is likely to be due to presence of concurrent morbidities and complications. Therefore, a shift from a disease-specific approach to a person-centred and integrated care approach could be beneficial in the treatment of type 2 diabetes. |
| format | Article |
| id | doaj-art-760e06d24d36452da7f4d4caa0240af6 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-760e06d24d36452da7f4d4caa0240af62024-12-10T06:30:10ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-049487Identifying and delineating the type 2 diabetes population in the Netherlands using an all-payer claims database: characteristics, healthcare utilisation and expendituresDirk Ruwaard0Henk J G Bilo1Rose J Geurten2Arianne M J Elissen3Jeroen N Struijs4Chantal van Tilburg5Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The NetherlandsDepartment of Internal Medicine, University Medical Centre Groningen, Groningen, The NetherlandsDepartment of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The NetherlandsDepartment of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The NetherlandsDepartment of Quality of Care and Health Economics, Center for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment (RIVM), Bilthoven, The NetherlandsDepartment Intelligence, Vektis Healthcare Information Center, Zeist, The NetherlandsObjectives We aimed to identify and delineate the Dutch type 2 diabetes population and the distribution of healthcare utilisation and expenditures across the health system from 2016 to 2018 using an all-payer claims database.Design Retrospective observational cohort study based on an all-payer claims database of the Dutch population.Setting The Netherlands.Participants The whole Dutch type 2 diabetes population (n=900 522 in 2018), determined based on bundled payment codes for integrated diabetes care and medication use indicating type 2 diabetes.Outcome measures Annual prevalence of type 2 diabetes, comorbidities and characteristics of the type 2 diabetes population, as well as the distribution of healthcare utilisation and expenditures were analysed descriptively.Results In 2018, 900 522 people (6.5% of adults) were identified as having type 2 diabetes. The most common comorbidity in the population was heart disease (12.1%). Additionally, 16.2% and 5.6% of patients received specialised care for microvascular and macrovascular diabetes-related complications, respectively. Most patients with type 2 diabetes received pharmaceutical care (99.1%), medical specialist care (97.0%) and general practitioner consultations (90.5%). In total, €8173 million, 9.4% of total healthcare expenditures, was reimbursed for the type 2 diabetes population. Medical specialist care accounted for the largest share of spending (38.1%), followed by district nursing (12.4%), and pharmaceutical care (11.5%).Conclusions All-payer claims databases can be used to delineate healthcare use: this insight can inform health policy and practice and, thereby, support better decisions to promote long-term sustainability of healthcare systems. The healthcare utilisation of the Dutch type 2 diabetes population is distributed across the health system and utilisation of medical specialist care is high. This is likely to be due to presence of concurrent morbidities and complications. Therefore, a shift from a disease-specific approach to a person-centred and integrated care approach could be beneficial in the treatment of type 2 diabetes.https://bmjopen.bmj.com/content/11/12/e049487.full |
| spellingShingle | Dirk Ruwaard Henk J G Bilo Rose J Geurten Arianne M J Elissen Jeroen N Struijs Chantal van Tilburg Identifying and delineating the type 2 diabetes population in the Netherlands using an all-payer claims database: characteristics, healthcare utilisation and expenditures BMJ Open |
| title | Identifying and delineating the type 2 diabetes population in the Netherlands using an all-payer claims database: characteristics, healthcare utilisation and expenditures |
| title_full | Identifying and delineating the type 2 diabetes population in the Netherlands using an all-payer claims database: characteristics, healthcare utilisation and expenditures |
| title_fullStr | Identifying and delineating the type 2 diabetes population in the Netherlands using an all-payer claims database: characteristics, healthcare utilisation and expenditures |
| title_full_unstemmed | Identifying and delineating the type 2 diabetes population in the Netherlands using an all-payer claims database: characteristics, healthcare utilisation and expenditures |
| title_short | Identifying and delineating the type 2 diabetes population in the Netherlands using an all-payer claims database: characteristics, healthcare utilisation and expenditures |
| title_sort | identifying and delineating the type 2 diabetes population in the netherlands using an all payer claims database characteristics healthcare utilisation and expenditures |
| url | https://bmjopen.bmj.com/content/11/12/e049487.full |
| work_keys_str_mv | AT dirkruwaard identifyinganddelineatingthetype2diabetespopulationinthenetherlandsusinganallpayerclaimsdatabasecharacteristicshealthcareutilisationandexpenditures AT henkjgbilo identifyinganddelineatingthetype2diabetespopulationinthenetherlandsusinganallpayerclaimsdatabasecharacteristicshealthcareutilisationandexpenditures AT rosejgeurten identifyinganddelineatingthetype2diabetespopulationinthenetherlandsusinganallpayerclaimsdatabasecharacteristicshealthcareutilisationandexpenditures AT ariannemjelissen identifyinganddelineatingthetype2diabetespopulationinthenetherlandsusinganallpayerclaimsdatabasecharacteristicshealthcareutilisationandexpenditures AT jeroennstruijs identifyinganddelineatingthetype2diabetespopulationinthenetherlandsusinganallpayerclaimsdatabasecharacteristicshealthcareutilisationandexpenditures AT chantalvantilburg identifyinganddelineatingthetype2diabetespopulationinthenetherlandsusinganallpayerclaimsdatabasecharacteristicshealthcareutilisationandexpenditures |