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. 2020 Oct 26;19(1):172.
doi: 10.1186/s12939-020-01291-4.

Projected impact of diabetes on the Costa Rican healthcare system

Carolina Santamaría-Ulloa  1 , Melina Montero-López  2
Affiliations

Projected impact of diabetes on the Costa Rican healthcare system

Carolina Santamaría-Ulloa et al. Int J Equity Health. .

Abstract

Introduction: Costa Rica, similar to many other Latin American countries is undergoing population aging at a fast pace. As a result of the epidemiological transition, the prevalence of diabetes has increased. This condition impacts not only individual lives, but also the healthcare system. The goal of this study is to examine the expected impact of diabetes, in terms of economic costs on the healthcare system and lives lost. We will also project how long it will take for the number of elderly individuals who are diabetic to double in Costa Rica.

Methods: CRELES (Costa Rican Longevity and Healthy Aging Study), a three-wave nationally representative longitudinal study, is the main source of data for this research (n = 2827). The projected impact of diabetes was estimated in three ways: length of time for the number of elderly individuals with diabetes to double; projected economic costs of diabetes-related hospitalizations and outpatient care; and years of life lost to diabetes at age 60. Data analyses and estimations used multiple regression models, longitudinal regression models, and Lee-Carter stochastic population projections.

Results: Doubling time of the diabetic elderly population is projected to occur in 13 calendar years. This will cause increases in hospitalization and outpatient consultation costs. The impact of diabetes on life expectancy at age 60 around the year 2035 is estimated to lead to a loss of about 7 months of life. The rapid pace at which the absolute number of elderly people with diabetes will double is projected to result in a negative economic impact on the healthcare system. Lives will also be lost due to diabetes.

Conclusion: Population aging will inevitably lead to an increasing number of elderly individuals, who are at greater risk for diabetes due to their lifelong exposure to risk factors. Actions to increase the quality of life of diabetic elderly are warranted. Decreasing the burden of diabetes on elderly populations and the Costa Rican healthcare system are necessary to impact the quantity and quality of life of incoming cohorts. Health promotion and prevention strategies that reduce diabetes risk factors are needed to improve the health of elderly populations.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Prevalence of diabetes in the elderly population by sex. Selected countries and cities (percentages). Source: Own elaboration based on results from Brenes-Camacho and Rosero-Bixby [8]; McDonald [29]; Andrade [2]
Fig. 2
Fig. 2
Projections of diabetic population size, and prevalence rate in the elderly. Costa Rica: 1996–2025 (Left y-axis refers to population (thousands), represented as solid bars. Right y-axis refers to the prevalence of diabetes in the elderly population (%), represented as a dotted line)
Fig. 3
Fig. 3
Projected annualized mean costs of hospitalization and outpatient consultations of the Costa Rican elderly population under the assumption of linear growth of diabetes prevalence (2011 USD)
Fig. 4
Fig. 4
Forecast of total life expectancy at birth based on all-cause mortality. Costa Rica: 1980–2035
Fig. 5
Fig. 5
Forecast of hypothetical total life expectancy removing diabetes as a cause of death. Costa Rica: 1980–2035
See this image and copyright information in PMC

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