Hospitalization Costs Due to Hypoglycemia in Patients with Diabetes: A Microcosting Approach
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ORIGINAL RESEARCH
Hospitalization Costs Due to Hypoglycemia in Patients with Diabetes: A Microcosting Approach Joa˜o P. Ferreira . Francisco Arau´jo . Jorge Dores . Le`lita Santos . ´ rcia Chipepo . Edite Nascimento . Esteva˜o Pape . Mo´nica Reis . A Ana Baptista . Vanessa Pires . Carlos Marques . Adriana S. Lages . Joa˜o Conceic¸a˜o . Pedro A. Laires . Joa˜o Pelicano-Romano . Sı´lvia Ala˜o
Received: May 11, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Hypoglycemia leading to hospitalization is associated with adverse economic outcomes, although the real burden is unknown. The HIPOS-WARD (Hypoglycemia In Portugal Observational Study-Ward) aimed to Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12490214. Electronic Supplementary Material The online version of this article (https://doi.org/10.1007/s13300020-00868-0) contains supplementary material, which is available to authorized users. J. P. Ferreira P. A. Laires J. Pelicano-Romano S. Ala˜o (&) MSD Portugal, Pac¸o de Arcos, Portugal e-mail: [email protected] ´ . Chipepo F. Arau´jo A ˆ ngelo, Loures, Portugal Hospital Beatriz A J. Dores Centro Hospitalar e Universita´rio Do Porto, Porto, Portugal L. Santos A. S. Lages Centro Hospitalar e Universita´rio de Coimbra, Coimbra, Portugal L. Santos Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal E. Pape Hospital Garcia de Orta, Almada, Portugal
characterize ward admissions due to hypoglycemia episodes in treated patients with diabetes and assess their economic impact to the National Health System. Methods: Observational, cross-sectional study, conducted in 16 Portuguese centers for 22 months. The applied microcosting approach was based on healthcare resource data, collected from patients’ charts upon ward admission until discharge, and unitary costs from official/ public data sources. Absenteeism was also estimated for active workers on the basis of the human capital approach.
M. Reis Hospital de Vila Franca de Xira, Vila Franca de Xira, Portugal E. Nascimento Centro Hospitalar Tondela Viseu, Viseu, Portugal A. Baptista Centro Hospitalar Universita´rio do Algarve-Faro, Faro, Portugal V. Pires Centro Hospitalar de Tra´s-Os-Montes E Alto Douro, Vila Real, Portugal C. Marques Unidade Local de Sau´de Do Baixo Alentejo, Beja, Portugal J. Conceic¸a˜o Medical Affairs, MSD International GmbH (Singapore Branch), Singapore, Singapore
Diabetes Ther
Results: Of the 176 patients with diabetes mellitus enrolled, 86% had type 2 diabetes. Half of the patients (50.0%) were on insulin-based therapy, followed by 30.1% on a secretagoguebased regimen, 9.7% on non-secretagogue therapy, and 10.2% on a combination of insulin and secretagogue. Overall mean costs per patient were medication, 45.45 €; laboratory analysis, 218.14 €; examinations, 64.91 €; physician and nurse time, 268.55 € and 673.39 €, respectively. Bed occupancy was the main cost driver (772.09 €) and indirect cost averaged 140.44 €. Overall, the cost per hypoglycemia episode leading
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