Economic impact of comorbid diabetes and associated racial disparities in managing Medicare beneficiaries with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS)

ABSTRACT

Clinical management of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is progressing to include chronic/metabolic complications, which may impose a significant economic burden on beneficiaries and Medicare. We assessed the national economic impact of comorbid Type-II Diabetes Mellitus (T2DM) on HIV/AIDS patients and potential raical disparities. This study was a cross-sectional study of Medicare database 2013–2017. Analytical sample included HIV/AIDS positive beneficiaries continuously enrolled in Part A/B. Total medical costs, prescription costs, inpatient costs, outpatient costs, out-of-pocket (OOP) costs, and Medicare costs were assessed from Medicare claims. Generalized linear models with log-link and gamma distribution were used to examine the impact of T2DM on different costs. A total of 2,509 eligible HIV/AIDS positive beneficiaries were identified of which 19.9% (n=498) had T2DM. After adjusting for covariates, T2DM beneficiaries had higher inpatient costs: 63.34% (95% CI: 42.73%−86.94%), outpatient costs: 50.26% (95% CI: 30.70%−72.75%), Medicare costs: 27.95% (95% CI: 13.81%−43.84%), OOP costs: 59.15% (95% CI: 40.02%−80.92%), and total medical costs: 27.83% (95% CI: 14.27%−43.00%) than non-T2DM beneficiaries. Incremental costs were higher among African Americans than Caucasians. Comorbid T2DM mposes a significant economic burden on HIV/AIDS patients and Medicare, which is higheramong African Americans.

KEYWORDS:

• Diabetes
• HIV/AIDS
• costs
• medicare
• race
• economic burden

Acknowledgement

Work on this article was supported in part by Office of the Vice President for Research, University of South Carolina.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Work on this article was supported in part by SPARC Research Grant, University of South Carolina.