Magdalena Annersten Gershater 1
* , Alexander Dozet 2 ,
Åsa Ericsson 3 and Slobodan Zdravkovic 1
1 Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden,
2 Corporate Office, Region Skåne, Malmö, Sweden, 3 National Market Access & Public Affairs, Novo
Nordisk, Malmö, Sweden
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https://www.frontiersin.org/journals/clinical-diabetes-and-healthcare/articles/10.3389/fcdhc.2025.1611426/full
Background:
With the prevalence of Type 2 Diabetes (T2D) projected to
increase, understanding its potential consequences on healthcare systems is
crucial for adequately preparing society to address this growing challenge. In
2019, Malmö, Sweden’s third-largest city, joined the Cities for Better Health
global initiative to tackle the multifaceted challenges associated with T2D,
including its significant economic burden on the healthcare system and the
broader community.
Understanding the economic burden of T2D on the
healthcare system will facilitate optimisation of the initiatives undertaken by
the programme. Therefore, this study aimed to estimate the costs associated
with primary care, hospital care, and work absenteeism due to diabetes-related
complications among people with T2D residing in Malmö.
Methods:
In order to estimate the cost for the City of Malmö, we expanded a
model (Andersson et al., 2020) developed to estimate the cost of T2D on a
national level, using retrospective data from 1997–2016. The costs were
estimated by using NordDRG weights and national reference prices. Primary
care costs for Region Skåne were added to the model. Data on healthcare
utilisation, work absence, and socioeconomic factors were collected from
Swedish national and regional registers. The method was expanded to include
Malmö-specific adjustments for demographics, employment, and education, as
well as regional primary care costs.
Results:
The prevalence of T2D in Malmö was 5.4%, and diabetes complications
were: diabetic retinopathy (49.9%), diabetic kidney disease (19.1%), angina
pectoris (13.7%), ischaemic heart disease (10.9%), and myocardial infarction
(10.5%).
Total excess costs for T2D in primary care were €12.7 million. The
lowest primary care excess costs were in the age group 16–34 and the highest in
the age group 65–74. Estimated overall hospital-based costs for T2D were €38.8
million, and costs related to macrovascular and microvascular complications
were €18.1 million and €16.4 million, respectively.
Estimated total cost due to
absence from work related to T2D complications was €15.4 million. The
complication costs were higher for men, except for neuropathy.
Conclusions:
These findings may support city-level healthcare planning and
preventive interventions, as Malmö is facing substantial costs both in monetary
terms and in reduced quality of life. Younger persons increasingly develop
diabetes complications, which needs to be considered when allocating
resources for primary prevention, treatment of complications, and municipality
costs within a near future
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https://www.frontiersin.org/journals/clinical-diabetes-and-healthcare/articles/10.3389/fcdhc.2025.1611426/full
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