Estimating the Cost of Complications of Diabetes in Australia Using Administrative Health-Care Data


Philip Clarke, School of Public Health, University of Sydney, Edward Ford Building, A27, University of Sydney, NSW 2006, Australia. E-mail:


Objectives:  To estimate Australian health-care costs in the year of first occurrence and subsequent years for major diabetes-related complications using administrative health-care data.

Methods:  The costs were estimated using administrative information on hospital services and primary health-care services financed through Australia's national health insurance system Medicare. Data were available for 70,340 patients with diabetes in Western Australia (mean duration of 4.5 years of follow-up). Multiple regression analysis was used to estimate inpatient and primary care costs.

Results:  For a man aged 60 years, the average costs in the year the event first occurred were: amputation $20,416 (95% CI 18,670–22,411); nonfatal myocardial infarction (MI) $11,660 (10,931–12,450); nonfatal stroke $14,012 (12,849–15,183); ischaemic heart disease $12,577 (12,026–13,123); heart failure $15,530 (13,965–17,009); renal failure $28,661 (22,989–34,202); and chronic leg ulcer $15,413 (13,089–18,123). The costs in subsequent years for a man aged 60 years range from 14% for nonfatal MI to 106% for renal failure, of event costs.

Conclusions:  Estimates of the health-care costs associated with diabetes-related complications can be used in modeling the long-term costs of diabetes and in evaluating the cost-effectiveness of improving care.