A cohort of children with type 1 diabetes in Greece: predictors of direct costs of care.

AimTo examine the predictors of direct costs of pediatric type 1 diabetes (T1D) in a hospital-based outpatient clinic in Greece. MethodsThe outpatient records of 89 children and adolescents (mean age: 12.055.15y) with T1D followed in the Second Department of Pediatrics, University of Athens Medical School, were analyzed. ResultsThe mean +/- SD diabetes duration was 4.9 +/- 3.88y (range: 0.25-17) and glycated hemoglobin (HbA1c) was 8.2 +/- 1.09% (66 +/- 11.9mmol/mol). A total of 80% of patients were on multiple daily injections regimen, 10% on pump therapy, and 10% on conventional regimen. Total direct costs per patient-year (ppy) were estimated at Euro2.712 [95% confidence interval (CI): 2.468-2.956]. Supply costs accounted for 73.7% of total costs and were the highest for pump therapy (P<.001). Multivariate linear regression analysis showed that costs were significantly higher for children (1) on multiple daily injections or pump therapy (r=0.364, P<.001), (2) of older age (r=0.25, P<.001) and (3) higher daily insulin dose (r=0.46, P<.001). Patients on pump therapy had significantly higher costs Euro5.538 (95%CI 4480-6597) compared with patients on multiple daily injections Euro2.447 (95% CI 2320-2574) and conventional regimen Euro1.978.5 (95%CI 1682-2275) (P=.0001). Patients on pump therapy had better glycemic control compared with all other patients [HbA1c (mean +/- SD): 7.2%+/- 1.0 vs 8.3% +/- 1.5, P=.039]. Conclusion The total T1D cost in this cohort of Greek children was Euro2712 ppy. The main factor that predicted direct cost was the use of pump. However, pump therapy was associated with better glycaemic control, which may decrease the risk of total long-term diabetes care cost.