The Health Care Cost Institute (HCCI) is pleased to present the 2014 Diabetes Health Care Cost and Utilization Report, with a principal focus on trends in health care spending and utilization for the national population younger than age 65 and covered by employer-sponsored insurance (ESI) with diagnosed diabetes. In this report, we also examine selected spending and utilization trends for the ESI population without diabetes (see box "Trends in Spending and Utilization of Health Care Services for People without Diabetes") and compare trends for the two populations--with and without diabetes--on selected spending and utilization measures. However, unless specifically stated, the discussion in this report is for the population with diabetes. This report covers the period 2012 to 2014 (the "study period"), with the bulk of the analysis focused on 2014. Additionally, this report is a follow-up publication to Per Capita Health Care Spending on Diabetes: 2009-2013, which can be found on the HCCI Website. Using the same general population as the previous report on the ESI population with diabetes, this report details trends in total per capita spending, per capita out-of-pocket spending, and utilization of health care services. These spending and use trends were created at the national level and broken down by age group and gender. Additionally, we studied trends for two broad types of services: medical (acute inpatient admissions, outpatient services, and professional services) and prescription (brand and generic; see box "Service Categories Analyzed in this Report" for more information). The American Diabetes Association (ADA) estimated that for the entire population of Americans with diagnosed diabetes in 2012, per capita spending on health care was $13,741.3 For that year (the most recent year that per capita health care spending estimates were available from the ADA), they found that per capita spending for people with diabetes was 3.9 times higher than spending for people without diabetes. This per capita figure for all Americans with diabetes was about $1,000 lower than the 2012 spending estimate for our study population (younger than 65 with ESI) with diabetes presented in this report ($14,711). We found that in 2012, per capita spending for our study population with diabetes was 3.56 times higher than spending for the study population without diabetes--a slightly lower figure than the ADA's estimate. Much of the difference between HCCI's and the ADA's spending estimates is probably due to population and methodological differences between the two samples. We estimated that between 2012 and 2014, per capita spending for the insureds with diabetes grew by $1,310 (Table 1). Further, by 2014, per capita spending for this population was 3.64 times higher than spending for the insureds without diabetes (Table 1 and Appendix Table A2). In addition to per capita spending trends, our report examines per capita out-of-pocket spending trends and the utilization rates of health care service use for the insureds with diabetes. This report proceeds in three sections: per capita spending trends, out-of-pocket spending trends, and utilization rates of health services. The findings from each of these sections and the similarities and differences in trends between the insured populations with and without diabetes as well as highlights for a few notable spending and utilization trends observed in our study populations are briefly noted below.
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