Evidence map›Paper›PMID 41199385›Full record

ArticleArchives of public health = Archives belges de sante publique2025

Impact of multimorbidity on healthcare costs in patients with type 2 diabetes in China: a longitudinal analysis of health insurance claims data.

Xing Chen, Luying Zhang, Wen Chen

Abstract read
In one paragraph

Article in Archives of public health = Archives belges de sante publique, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Xing ChenShanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
Luying ZhangSchool of Public Health, Fudan University, Shanghai, China. zhangluying@fudan.edu.cn.
Wen ChenShanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.

Funding

National Natural Science Foundation of China 72342016National Natural Science Foundation of China 72374049
6 · The paper itself

Abstract

backgroundMultimorbidity is highly prevalent among individuals with diabetes and exerts a substantial impact on healthcare systems. This study aims to investigate the prevalence and healthcare costs of multimorbidity in patients with type 2 diabetes and to assess the influence of multimorbidity on healthcare expenditures using machine learning approaches.

methodsWe conducted a retrospective cohort study utilizing chronic disease management database and health insurance claim database from a city in eastern China. Twenty-nine multimorbidities with a prevalence exceeding 1% among diabetic patients were identified using ICD codes. We analyzed the trends in prevalence and healthcare costs from 2014 to 2019. Machine learning models were developed to predict healthcare expenditures, and SHAP analysis was applied to the optimal model to evaluate the contribution of specific multimorbidity to healthcare costs.

resultsAmong 79,910 patients, the prevalence of multimorbidity increased from 87.9% in 2014 to 99.3% in 2019, while the proportion of healthcare costs attributed to multimorbidity rose from 31.8% to 34.2%. In 2019, the most prevalent conditions were hypertension (88.3%), arthritis (74.7%), and chronic ischemic heart disease (54.6%), whereas the highest-cost conditions included sequelae of cerebrovascular disease ($3,860.8), cerebral infarction ($2,768.8), and renal failure ($1,543.9). SHAP analysis revealed that cerebrovascular disease sequelae, heart failure, chronic ischemic heart disease, and chronic obstructive pulmonary disease had the most significant impact on future healthcare costs for diabetic patients.

conclusionsMultimorbidity is nearly universal among individuals with diabetes in China, with cardiovascular, cerebrovascular, and chronic respiratory diseases contributing disproportionately to healthcare expenditures.

Indexed as

Claims dataDiabetesHealthcare costMultimorbidityPrevalence

Identifiers

PMID41199385
PMCPMC12590856

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.