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Incremental healthcare expenditure attributable to diabetes mellitus: a cost of illness study in Tasmania, Australia


Dinh, HTT and de Graaff, B and Campbell, JA and Jose, MD and Burgess, JR and Saunder, T and Kitsos, A and Wiggins, N and Palmer, AJ, Incremental healthcare expenditure attributable to diabetes mellitus: a cost of illness study in Tasmania, Australia, Diabetic Medicine, 39, (6) Article e14817. ISSN 0742-3071 (2022) [Refereed Article]

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Copyright Statement

This is the peer reviewed version of the following article: Dinh, NTT, de Graaff, B, Campbell, JA, et al. Incremental healthcare expenditure attributable to diabetes mellitus: A cost of illness study in Tasmania, Australia. Diabet Med. 2022; 00:e14817, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

DOI: doi:10.1111/dme.14817



To quantify the incremental direct medical costs in people with diabetes from the healthcare system perspective; and to identify trends in the incremental costs.


This was a matched retrospective cohort study based on a linked dataset developed for investigating chronic kidney disease in Tasmania, Australia. Using propensity score matching, 51,324 people with diabetes were matched on age, sex, and residential area with 102,648 people without diabetes. Direct medical costs (Australian dollars 2020-2021) due to hospitalisation, Emergency Department visits and pathology tests were included. The incremental costs and cost ratios between mean annual costs of people with diabetes and their controls were calculated.


On average, people with diabetes had healthcare costs that were almost double their controls ($2,427 (95% CI 2,322-2,543); ratio 1.87 (95% CI 1.85-1.91); pooled from 2007-2017). While in the first year of follow-up, the costs of a person with diabetes were $1,643 (95% CI 1,489-1,806); ratio 1.83 (95% CI 1.76-1.92) more than their control, this increased to $2,480 (95% CI 2,265-2,680); ratio 1.69 (95% CI 1.62-1.77) in the final year. Although the incremental costs were higher in older age groups (e.g., ≥70: $2,498 (95% CI 2,265-2,754); 40-49: $2,117 (95% CI 1,887-2,384)), the cost ratios were higher in younger age groups (≥70: 1.52 (95% CI 1.48-1.56); 40-49: 2.37 (95% CI 2.25-2.61)).


Given the increasing burden that diabetes imposes, our findings will support policymakers in future planning for diabetes and enable targeting sub-groups with higher long-term costs for possible cost savings for the Tasmanian healthcare system.

Item Details

Item Type:Refereed Article
Keywords:diabetes, costs, hospitalisation, linked data, Tasmania, Australia, cost of illness, data linkage, records linkage
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Endocrinology
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Public health (excl. specific population health) not elsewhere classified
UTAS Author:Dinh, HTT (Ms Thi Thu Ngan Dinh)
UTAS Author:de Graaff, B (Dr Barbara de Graaff)
UTAS Author:Campbell, JA (Dr Julie Campbell)
UTAS Author:Jose, MD (Professor Matthew Jose)
UTAS Author:Burgess, JR (Professor John Burgess)
UTAS Author:Saunder, T (Mr Timothy Saunder)
UTAS Author:Kitsos, A (Mr Alex Kitsos)
UTAS Author:Wiggins, N (Mrs Nadine Wiggins)
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:148846
Year Published:2022
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-02-16
Last Modified:2022-05-16

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