Cost of hospitalisation and length of stay due to hypoglycaemia in patients with diabetes mellitus: a cross-sectional study

Abstract

Objective: This study aims to estimate the length of stay and hospitalisation cost of hypoglycaemia, and to identify determinants of variation in the length of stay and hospitalisation cost among individual patients with type 1 or 2 diabetes mellitus. 
 Methods: A cross-sectional study was conducted using inpatients records for patients with diabetes mellitus who had been hospitalised due to hypoglycaemic events in two private hospitals in Amman, Jordan between January 2009 and May 2017. All hospitalisation costs were inflated to the equivalent costs in 2017. Hospitalisation cost was estimated from the patient’s perspective in Jordanian dinars (JOD). Descriptive analyses and correlation between sociodemographic or clinical characteristics with the cost and length of stay were explored. Predictors of hypoglycaemic hospitalisation cost and length of stay were determined using logistic regression.
 Results: During the study period a total of 126 patients with diabetes mellitus were hospitalised due to an incident of hypoglycaemia. The mean patient age was 64.2 (SD=19.6) years; half were male. Patients admitted for hypoglycaemia stayed in hospital for a median duration of two days (IQR=2 days). The median cost of hospitalisation for hypoglycaemia was 163.2 JOD (USD 230.1) (IQR=216.3 JOD). We found that the Glasgow coma score was positively associated with length of stay (0.345, p=0.008), and older age was correlated with higher hospitalisation cost (0.207, p=0.02). Patients with a family history of diabetes had higher hospitalisation costs and longer duration of stay (0.306 and 0.275, p<0.05). In addition, being a male patient (0.394, p<0.05) and with an absence of smoking history was associated with longer duration of stay (0.456, p<0.01), but not with higher hospitalisation cost.
 Conclusions: Costs associated with the incidence of hypoglycaemic events are not low and constitute a large cost component of managing and treating diabetes mellitus. Male patients and patients having a family history of diabetes should receive extra care and education on the prevention of hypoglycaemic events, and a treatment de-intensification approach should be considered if necessary, so we can prevent its associated hospitalisation costs and length of stay.

The Health-Related Quality of Life of Patients with Type 2 Diabetes in Saudi Arabia

“… 7 Frequent hospitalisation that could lead to financial loss, job loss, diminished interaction with family, psychological effects, and other issues is an example of the effects of DM on QoL. 8 However, DM is not the only factor that can affect the QoL of a diabetic patient. According to the World Health Organization (WHO), QoL is defined as “an individual’s perceptions of their position in life in the context of the culture and value systems in which they live, and in relation to their goals, expectations, standards, and concerns.…”

Economic costs of hospitalisation and length of stay in diabetes with coexisting hypertension with correlation to laboratory investigations: Where does India stand? A 5‐year ground report

“…Similar results were obtained in the study reported by Naser et al for LOS, but opposite results were reported for hospitalisation costs. 35 During the study, it was observed that fasting blood sugar (FBS) 261-290 mg/dL and >290 mg/dL (P = .012). The mean difference is considered significant at the 0.03 level.…”

“…In India, approximately 73 million people living with diabetes, and another 37 million with prediabetes, while nearly 47% of the diabetes cases are undiagnosed 46. Several studies have shown that age, poor education, family history of diabetes, physical inactivity and obesity were risk factors of DM coexisting HTN 33,35,[47][48][49][50][51][52]. The Ministry of Health, Government of India, has initiated an insurance scheme 'World's biggest health reforms: Ayushman Bharat-National Health Protection Scheme' in 2018 claiming benefited to around 500 million citizens of the country 53,54.…”

Mental Wellbeing and Quality of Life Among Patients With Diabetes Suffering From Hypoglycaemia in Saudi Arabia

“…According to the World Health Organization (WHO), Saudi Arabia is ranked second among the highest percentages of diabetes worldwide, with more than 7 million patients with diabetes reported in 2017 [2], with the prevalence being estimated to be around 14% [1]. Patients with diabetes are usually treated with pharmacological treatment to control their blood sugar levels, and this put them at higher risk of developing some life-threatening and costly complications such as hypoglycaemia [3][4][5].…”