Trends in Health Expenditures for Chronic Disease Management: Hypertension, Diabetes Mellitus, and Dyslipidemia from 2013 to 2020

Abstract

Purpose: Chronic diseases such as hypertension (HT), diabetes mellitus (DM), and dyslipidemia (LD) are leading contributors to healthcare expenditures globally, including in South Korea. This study aimed to analyze trends in health expenditures for managing these conditions, focusing on patient demographics, comorbidities, and complications, using real-world data from a tertiary care hospital. Materials and Methods: This retrospective study utilized clinical data from Severance Hospital's Severance Clinical Research Analysis Portal (SCRAP) system, covering 2013 to 2020. Patients diagnosed with HT, DM, and LD were identified using ICD-10 codes. Generalized linear mixed models were applied to evaluate trends in health expenditures, and a Sankey diagram was used to visualize expenditure flows by patient subgroups and care categories. Results: Total health expenditures increased nearly threefold, from 157.2 billion KRW in 2013 to 444.8 billion KRW in 2020, driven primarily by rising reimbursable costs (67.1% to 84.1%). Per-patient expenditures decreased initially but stabilized by 2020. Patients with HT+DM incurred the highest per-patient costs, followed by those with HT alone. Complications, particularly cardiovascular and cerebrovascular diseases, significantly elevated costs, with inpatient care accounting for the largest expenditure share. Conclusion: The economic burden of managing chronic diseases is substantial, particularly for patients with multiple conditions or complications. Strengthening preventive care and integrated management strategies, alongside sustained financial support, is crucial for improving cost-efficiency in chronic disease care.