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Lookup NU author(s): Dr Sue BellassORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. Background: Approximately 60 000 people in England have coexisting type 2 diabetes mellitus (T2DM) and severe mental illness (SMI). They are more likely to have poorer health outcomes and require more complex care pathways compared with those with T2DM alone. Despite increasing prevalence, little is known about the healthcare resource use and costs for people with both conditions. Aims: To assess the impact of SMI on healthcare resource use and service costs for adults with T2DM, and explore the predictors of healthcare costs and lifetime costs for people with both conditions. Method: This was a matched-cohort study using data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics for 1620 people with comorbid SMI and T2DM and 4763 people with T2DM alone. Generalised linear models and the Bang and Tsiatis method were used to explore cost predictors and mean lifetime costs respectively. Results: There were higher average annual costs for people with T2DM and SMI (£1930 higher) than people with T2DM alone, driven primarily by mental health and non-mental health-related hospital admissions. Key predictors of higher total costs were older age, comorbid hypertension, use of antidepressants, use of first-generation antipsychotics, and increased duration of living with both conditions. Expected lifetime costs were approximately £35 000 per person with both SMI and T2DM. Extrapolating nationally, this would generate total annual costs to the National Health Service of around £250 m per year. Conclusions: Our estimates of resource use and costs for people with both T2DM and SMI will aid policymakers and commissioners in service planning and resource allocation.
Author(s): Wang H-I, Han L, Jacobs R, Doran T, Holt RIG, Prady SL, Gilbody S, Shiers D, Alderson S, Hewitt C, Taylor J, Kitchen CEW, Bellass S, Siddiqi N
Publication type: Article
Publication status: Published
Journal: British Journal of Psychiatry
Year: 2022
Volume: 221
Issue: 1
Pages: 402-409
Print publication date: 01/07/2022
Online publication date: 21/09/2021
Acceptance date: 08/08/2021
Date deposited: 17/07/2025
ISSN (print): 0007-1250
ISSN (electronic): 1472-1465
Publisher: Cambridge University Press
URL: https://doi.org/10.1192/bjp.2021.131
DOI: 10.1192/bjp.2021.131
Data Access Statement: Researchers can apply to access Clinical Practice Research Datalink (CPRD) data with linkage to Hospital Episode Statistics (HES) through https://www.cprd.com/. Data sharing agreements with CPRD do not permit data sharing with third parties. All formulae and additional sources of information are presented in the paper and Supplementary materials. The SAS and stata code for cleaning and analysing the data can be provided upon reasonable request.
PubMed id: 35049484
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