Evidence map›Paper›PMID 39826136›Full record

ArticleJournal of periodontology2025

Differences in health care expenditure due to the comorbidity status of periodontal disease and diabetes mellitus.

Anna Kinugawa, Kenji Takeuchi, Yudai Tamada, Taro Kusama, Misuzu Sato, Megumi Maeda, Fumiko Murata, Ken Osaka, Haruhisa Fukuda

Abstract read
In one paragraph

Article in Journal of periodontology, 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

9 authors.

Anna KinugawaDepartment of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.ORCID https://orcid.org/0000-0003-3988-765X
Kenji TakeuchiDepartment of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.ORCID https://orcid.org/0000-0001-8769-8955
Yudai TamadaDepartment of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.ORCID https://orcid.org/0000-0001-6868-4195
Taro KusamaDepartment of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.ORCID https://orcid.org/0000-0001-8683-4484
Misuzu SatoDepartment of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.ORCID https://orcid.org/0000-0002-4752-8852
Megumi MaedaDepartment of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Fumiko MurataDepartment of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Ken OsakaDepartment of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.
Haruhisa FukudaDepartment of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.

Funding

Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS) KAKENHI 22H03299Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS) KAKENHI 23K24557Health Labour Sciences Research Grant from the Ministry of Health, Labour and Welfare, Japan 23FA1022Health Labour Sciences Research Grant from the Ministry of Health, Labour and Welfare, Japan 24FA1020Japan Agency for Medical Research and Development JP23ek0210191JST FOREST Program Grant from the Japan Science and Technology Agency JPMJFR205J
6 · The paper itself

Abstract

backgroundTo investigate the differences in health care expenditure (HCE) due to the comorbidity status of periodontal disease (PD) and diabetes mellitus (DM).

methodsThis cohort study used health care claims and oral health screening data to identify participants with PD or DM and followed them for 1 year to assess their HCE. PD and DM were determined based on PD screening and medical claims data, respectively. The study participants were divided into four groups: participants without PD and DM (PD-/DM-), participants with PD and without DM (PD+/DM-), participants without PD and with DM (PD-/DM+), and participants with PD and DM (PD+/DM+). Covariates included age, sex, smoking status, and Charlson Comorbidity Index (CCI) score. A generalized linear model (GLM) with a gamma distribution and log link function was used to examine the association between comorbidity and annual HCE, and a two-part model was used to assess the differences in annual HCE.

resultsIn total, 790 participants (mean age: 63.1, 30.3% male) were included. Compared with the PD-/DM- group, the relative cost ratio (RCR) for the PD+/DM+, PD-/DM+, PD+/DM- groups were 1.31 (95% confidence interval [CI]: 1.06-1.62), 1.27 (95% CI: 0.99-1.64), 1.01 (95% CI: 0.89-1.14) times higher, respectively. The adjusted mean annual HCE for the PD+/DM+, PD-/DM+, PD+/DM- groups were ¥59,328 (95% CI: 14,171-104,484), ¥50,228 (95% CI: -15,801-116,256), ¥-2,162 (95% CI: -24,598-20,274) higher than the PD-/DM- group, respectively.

conclusionThis study provides a significant contribution of PD to the increase in HCE, particularly in individuals with DM. PLAIN LANGUAGE SUMMARY: The association between periodontal disease (PD) and diabetes mellitus (DM) has commonly been described in previous literature, but the health expenditure incurred when PD and DM coexist is not clear. This study investigates the differences in health care expenditure (HCE) due to the comorbidity status of PD and DM. HCE is calculated from medical, dental, and pharmacy-dispensing expenditures from the claims data. PD was defined by periodontal pocket scores, and DM was determined based on medical records. Study participants were divided into four groups based on whether they had PD, DM, both, or neither. The results showed that people with both PD and DM had higher HCE compared with those without PD and DM. These findings may suggest the importance of cooperation between medical and dental professionals in the treatment of DM in terms of HCE.

Indexed as

Diabetes MellitusHealth ExpendituresPeriodontal DiseasesAdultAgedCohort StudiesComorbidityFemaleHumansMaleMiddle Ageddiabetesepidemiologyhealth care costshealth service researchperiodontal diseasespreventive dentistry

Identifiers

PMID39826136
PMCPMC12312076

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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 OpenQuestion graph.