Medical Cost and Healthcare Utilization in Adults with Chronic Kidney Disease and Type 2 Diabetes in a Chinese Regional Population.

INTRODUCTION: Patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) face high medical and economic burdens. However, information on healthcare utilization and medical expenditures for these patients in China is limited. This study aims to describe these aspects in a regional population in China. METHODS: Adult patients with CKD and T2DM from an electronic health record (EHR)-based longitudinal cohort study in Yinzhou, Ningbo, China were included between 2017 and 2020. Annual medical costs in Chinese yuan (CNY) and their equivalent in United States dollars (USD) and healthcare utilization (length of hospital stay, outpatient visits) were described by CKD stages. Two-part models estimated medical costs and healthcare utilization for each CKD stage. RESULTS: A total of 16,521 patients were included. The average total medical cost for all patients increased from 7087 (14,432) [mean (SD)] in 2017 to 10,901 (30,621) CNY in 2020. Medical costs across CKD stages increased in both outpatient visit expenses and hospitalization costs. In particular, hospitalization costs for patients with G3 increased from 3963 (12,497) to 9970 (39,513) CNY, and for G4 from 12,394 (24,571) to 19,421 (48,299) CNY. Overall, two-part model estimation results showed that outpatient visits increased from 11.8 (10.4) times in 2017 to 12.9 (11.1) in 2020, and length of stay increased from 3.4 (10.9) to 4.5 (16.7) days. CONCLUSIONS: The study revealed that outpatient visits were main healthcare delivery method across CKD stages, with rising medical costs and healthcare utilization, especially hospitalization costs in G3 and G4. These findings highlight the need for efficient outpatient management and timely interventions in China.