The Burden and Impact of Diabetes on Society

Diabetes has become a prevalent global disease, bringing about high medical costs that pose a considerable burden on both patients and society. Beyond the direct costs associated with diabetes, various complications and comorbidities contribute to significantly elevated healthcare expenses for patients. According to statistics from the National Health Insurance Administration under the Ministry of Health and Welfare in Taiwan, the healthcare cost for diabetic patients is 4.3 times higher than that for non-diabetic individuals. Moreover, medical costs increase with poor blood sugar control (HbA1C concentration), making it a substantial and noteworthy societal issue.

According to the "2019 Taiwan Diabetes Yearbook - Type 2 Diabetes," approximately 160,000 new cases of diabetes are reported in Taiwan each year, with the majority being Type 2 diabetic patients. The healthcare costs associated with diabetes can be categorized into two main parts： (1) direct costs and (2) indirect costs.

(1) Direct Costs: Medical Expenses Due to Diabetes

According to the "National Health Insurance Medical Statistics Annual Report" published by the Ministry of Health and Welfare, the declared medical expenses for diabetes as the main diagnosis have been steadily increasing. From 2010 (99th year of the Republic of China) , it has risen to 253.9 billion points by the year 2019, with an average annual growth rate of 6.1%. The proportion of diabetes-related medical expenses to the total National Health Insurance costs has remained stable at 2.9-3.9% over the past decade. Globally, diabetes-related medical expenses account for approximately 12% of total healthcare expenditures. Examining outpatient and inpatient medical costs for diabetic patients based on data until 2019, the average hospitalization rate for diabetic patients is 15.1%, with an average hospital stay of 9-10 days and an average hospitalization cost of 61,809 points. The outpatient cost for 2019 averaged 1,972 points.

(2) Indirect Costs: Productivity Losses Due to Disability or Premature Death Caused by Diabetes

Regarding indirect costs, studies in Taiwan have used the human capital approach, taking factors such as age at diabetes-related death, average remaining life expectancy, labor force participation, and unemployment rate into account to estimate productivity losses due to premature death caused by diabetes. According to research results, the total productivity loss in 2011 due to premature death caused by diabetes reached up to NT$8.6 billion, with approximately NT$7.2 billion for males (84%) and NT$1.3 billion for females. According to global burden of disease estimates, Taiwan had 385,000 disability-adjusted life years (DALYs) attributable to diabetes in 2019, with 203,000 years of life lost (YLL). Another notable issue is that diabetes is a major cause of death and disability in Taiwan, resulting in both the loss of working days for patients and the accompanying family members, indicating significant indirect medical costs and a considerable impact on the socio-economic aspect.

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