Direct diabetes-related healthcare expenditures in Slovenia: recent evolution and future projections based on population-level data

ABSTRACT

Objective

The burden of diabetes on individuals, healthcare systems, and society must be explored to improve and sustain diabetes care. With this aim, we estimated both past and future diabetes-related direct health expenditures in Slovenia.

Methods

Analysis of expenditures from the healthcare payer perspective during the 2019–2022 period was based on individual patient data on expenditures for seven groups of diabetes-related medical conditions from the population-level database of the Health Insurance Institute of Slovenia. Expenditure projections were prepared using the European Commission’s methodology for budgetary projections.

Results

In the 2019–2022 period, average annual diabetes-related expenditures equaled €174.1 million (€1,108 per patient), with their average annual growth rate reaching 12.5%. Expenditures due to inpatient care (33%) and drugs used in diabetes (24%) had the highest shares. More than half of the expenditures were due to complications of diabetes. The diabetes-related expenditures as a share of GDP are projected to increase by 19.2% from 2019 to 2030, with slower yet continued growth up to 2050.

Conclusions

Diabetes-related expenditures in Slovenia continue to rise. By focusing on the prevention and optimal management of diabetes, its impact on the healthcare system could be reduced significantly, given the magnitude of expenditures attributed to complications.

Plain Language Summary

Diabetes is a chronic metabolic disease characterized by elevated blood sugar levels, leading to serious damage to the heart, blood vessels, eyes, kidneys, and nerves. The number of patients with diabetes has been increasing and accounted for about 10% of the world’s population aged 20–79 years in 2021. Diabetes and its complications also represent a substantial economic burden for individuals, healthcare systems, and society. Using data extracted from the database of the Health Insurance Institute of Slovenia, we looked at the direct healthcare expenditures related to diabetes over the 2019–2022 period and estimated their future trends. During the observed period, the average annual diabetes-related expenditures from the healthcare payer perspective equaled €174.1 million (€1,108 per patient), with their average annual growth rate reaching 12.5%. Expenditures due to hospitalizations (33%) and drugs used in diabetes (24%) had the highest shares. More than half of the expenditures were due to the complications of diabetes. Diabetes-related expenditures as a share of GDP are projected to increase by 19.2% from 2019 to 2030, with slower yet continued growth up to 2050. Our results confirm the growing economic burden of diabetes in Slovenia. Given that modifiable risk factors significantly contribute to the development of diabetes, primary prevention programs to promote healthy lifestyles need to be strengthened. By improving the detection of diabetes and managing it optimally, the progression of the disease and the occurrence of its costly complications can also be prevented considerably.

KEYWORDS:

• Complications
• diabetes
• direct healthcare expenditures
• payer perspective
• projections of expenditures
• Slovenia

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter discussed in the paper.

Author contributions

P Došenović Bonča and K Janša were involved in the conception and design of this study, the analysis, interpretation of the results, and drafting/revising the paper for intellectual content. D Gavrić and J Sambt were involved in data collection, the analysis and revising the paper for intellectual content. All authors gave the final approval for this paper to be published.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2024.2302423

Additional information

Funding

This work was partially founded by the following Slovenian Research Agency grants: [P5-0117], [P5-0128].