open access

Vol 9, No 6 (2020)
Research paper
Published online: 2020-11-10
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Cost and quality of diabetes care: comparisons between Rzeszow, Podkarpacie, Poland and Waukesha, Wisconsin, United States

John Idso, Grzegorz Telega, Dąbrowski Mariusz, Steven B. Magill, Srividya Kidambi
DOI: 10.5603/DK.2020.0051
·
Clinical Diabetology 2020;9(6):469-474.

open access

Vol 9, No 6 (2020)
ORIGINAL ARTICLES
Published online: 2020-11-10

Abstract

Background. The cost of diabetes care increases worldwide and is highest in the United States (US), while the quality of care remains unsatisfactory. The aim of this study was to compare the quality and cost of type 2 diabetes mellitus (DM) care between Waukesha, Wisconsin, US and Rzeszów, Poland.
Methods. DM quality data for the Polish cohort were abstracted from the charts of 79 DM patients in Rzeszow, Podkarpacie from 1 January 2013 to 31 December 2014. Cost data were attained from the Polish National Health Fund. Seventy-nine DM patients, matched for age, body mass index, and sex, from Waukesha, Wisconsin were chosen as comparators. DM quality data was obtained from the medical record and cost data from health system decision support staff.
Results. Average HbA1c (%, mean ± SD) in the Polish and US cohorts were 7.4 ± 1.4 and 8.0 ± 2.1, respectively (P = 0.03). Mean systolic/diastolic blood pressure (mm Hg) in the two cohorts was 150 ± 17/81 ± 12 and 132 ± 17/74 ± 11 (P < 0.001), respectively. The rates of statin usage were 90% and 86% (P = 0.45), respectively. Costs of direct medical care (hospitalizations, outpatient care, and medications) in the Polish and US cohorts were 1,263 US dollars (USD) and 10,121 USD, per annum, respectively.
Conclusion. This study reports significant differences in cost with relatively small differences in quality and of DM care between Poland and the US. As the US continues to attempt healthcare reform in order to decrease cost and increase quality, this study suggests that gains in cost and quality may not be mutually exclusive.

Abstract

Background. The cost of diabetes care increases worldwide and is highest in the United States (US), while the quality of care remains unsatisfactory. The aim of this study was to compare the quality and cost of type 2 diabetes mellitus (DM) care between Waukesha, Wisconsin, US and Rzeszów, Poland.
Methods. DM quality data for the Polish cohort were abstracted from the charts of 79 DM patients in Rzeszow, Podkarpacie from 1 January 2013 to 31 December 2014. Cost data were attained from the Polish National Health Fund. Seventy-nine DM patients, matched for age, body mass index, and sex, from Waukesha, Wisconsin were chosen as comparators. DM quality data was obtained from the medical record and cost data from health system decision support staff.
Results. Average HbA1c (%, mean ± SD) in the Polish and US cohorts were 7.4 ± 1.4 and 8.0 ± 2.1, respectively (P = 0.03). Mean systolic/diastolic blood pressure (mm Hg) in the two cohorts was 150 ± 17/81 ± 12 and 132 ± 17/74 ± 11 (P < 0.001), respectively. The rates of statin usage were 90% and 86% (P = 0.45), respectively. Costs of direct medical care (hospitalizations, outpatient care, and medications) in the Polish and US cohorts were 1,263 US dollars (USD) and 10,121 USD, per annum, respectively.
Conclusion. This study reports significant differences in cost with relatively small differences in quality and of DM care between Poland and the US. As the US continues to attempt healthcare reform in order to decrease cost and increase quality, this study suggests that gains in cost and quality may not be mutually exclusive.

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Keywords

diabetes, the cost of care, quality of care, Poland, United States

About this article
Title

Cost and quality of diabetes care: comparisons between Rzeszow, Podkarpacie, Poland and Waukesha, Wisconsin, United States

Journal

Clinical Diabetology

Issue

Vol 9, No 6 (2020)

Article type

Research paper

Pages

469-474

Published online

2020-11-10

DOI

10.5603/DK.2020.0051

Bibliographic record

Clinical Diabetology 2020;9(6):469-474.

Keywords

diabetes
the cost of care
quality of care
Poland
United States

Authors

John Idso
Grzegorz Telega
Dąbrowski Mariusz
Steven B. Magill
Srividya Kidambi

References (29)
  1. Davis K. Slowing the growth of health care costs--learning from international experience. N Engl J Med. 2008; 359(17): 1751–1755.
  2. Shi L, Singh D. Delivering health care in America: a systems approach. Sixth edition. Jones & Bartlett Learning, Burlington 2015.
  3. Health resources - Health spending - OECD Data. Organization for Economic Cooperation and Development. http://data.oecd.org/healthres/health-spending.htm (19.04.2018).
  4. Health status - Life expectancy at birth - OECD Data. theOECD. http://data.oecd.org/healthstat/life-expectancy-at-birth.htm (19.04.2018).
  5. Glass RI. What the United States has to gain from global health research. JAMA. 2013; 310(9): 903–904.
  6. American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care. 2018; 41(5): 917–928.
  7. Ozieh MN, Bishu KG, Dismuke CE, et al. Trends in health care expenditure in U.S. adults with diabetes: 2002-2011. Diabetes Care. 2015; 38(10): 1844–1851.
  8. Mata-Cases M, Casajuana M, Franch-Nadal J, et al. Direct medical costs attributable to type 2 diabetes mellitus: a population-based study in Catalonia, Spain. Eur J Health Econ. 2016; 17(8): 1001–1010.
  9. Dawson KG, Gomes D, Gerstein H, et al. The economic cost of diabetes in Canada, 1998. Diabetes Care. 2002; 25(8): 1303–1307.
  10. Köster I, Huppertz E, Hauner H, et al. Direct costs of diabetes mellitus in Germany - CoDiM 2000-2007. Exp Clin Endocrinol Diabetes. 2011; 119(6): 377–385.
  11. Anderson GF, Chalkidou K. Spending on medical care: more is better? JAMA. 2008; 299(20): 2444–2445.
  12. Dieleman JL, Squires E, Bui AL, et al. Factors Associated With Increases in US Health Care Spending, 1996-2013. JAMA. 2017; 318(17): 1668–1678.
  13. Hussey PS, Wertheimer S, Mehrotra A. The association between health care quality and cost: a systematic review. Ann Intern Med. 2013; 158(1): 27–34.
  14. About the Froedtert & MCW Health Network | Froedtert & the Medical College of Wis. https://www.froedtert.com/about (19.04.2019).
  15. Information Service Rzeszow - Rzeszow in numbers. http://www.rzeszow.pl/miasto-rzeszow/dane-statystyczne/rzeszow-w-liczbach (25.04.2018).
  16. American FactFinder - Community Facts. U.S. Census Bureau. https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml# (25.04.2018).
  17. Purchasing Power Parities for GDP and Related Indicators. OECD; 2018.
  18. Vogel F. What Is a Purchasing Power Parity? World Bank 4.
  19. American Diabetes Assocation. Standards of Medical Care in Diabetes. Diabetes Care. 2018; 41(Supplement 1).
  20. Sagan A, Panteli D, Borkowski W, et al. Poland health system review. Health Syst Transit. 2011; 13(8): 1–193.
  21. Rogers A, Weiss ST. Epidemiologic and Population Genetic Studies. Clinical and Translational Science. 2017: 313–326.
  22. Peterson KA, Radosevich DM, O'Connor PJ, et al. Improving Diabetes Care in Practice: findings from the TRANSLATE trial. Diabetes Care. 2008; 31(12): 2238–2243.
  23. Diabetes: Statin Use Unless Contraindicated. Wisconsin Collaborative for Healthcare Quality; 2017.
  24. Kudaj-Kurowska A, Turek I, Józefowska M, et al. [The metabolic control in type 2 diabetic patients according to Polish Diabetes Association recommendation]. Diabet Klin. 2014; 3 (3): 92–99.
  25. Leśniowska J, Schubert A, Wojna M, et al. Costs of diabetes and its complications in Poland. Eur J Health Econ. 2014; 15(6): 653–660.
  26. Orszag PR, Ellis P. Addressing rising health care costs--a view from the Congressional Budget Office. N Engl J Med. 2007; 357(19): 1885–1887.
  27. Chernew ME, Baicker K, Hsu J. The specter of financial armageddon--health care and federal debt in the United States. N Engl J Med. 2010; 362(13): 1166–1168.
  28. Spiro T, Lee EO, Emanuel EJ. Price and utilization: why we must target both to curb health care costs. Ann Intern Med. 2012; 157(8): 586–590.
  29. Bodenheimer T, Fernandez A. High and rising health care costs. Part 4: can costs be controlled while preserving quality? Ann Intern Med. 2005; 143(1): 26–31.

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