Abstract
BackgroundThe incidence of type 2 diabetes is increasing, creating a huge burden for China’s social healthcare system. This study aimed to evaluate hospital length of stay (LOS) based on admission characteristics and direct costs correlated with various types of complications for type 2 diabetic inpatients in Hubei Province, China.MethodsA total of 1528 inpatients diagnosed with type 2 diabetes discharged between April 1, 2013, and March 31, 2014, were included in this study. Information regarding patients’ admission and hospitalization were obtained from the hospital information system. The relationship between admission characteristics and LOS, distribution of total costs, and types of complications were described and analysed.Results(1) The mean LOS was 11.65 days (median: 10 days). Multiple linear regression analysis demonstrated that inpatients with New Cooperative Medical Scheme (NCMS), aged 80 and above, had longer LOS than the reference group, and inpatients with chronic or acute + chronic complications had shorter LOS than those without. (2) Mean total costs per patient were US$159.72 ± 130.83 (median: US$135.33), US$240.60 ± 166.58 (median: US$192.09), and US$247.98 ± 166.22 (median: US$200.99) for inpatients with no complications, chronic complications, and acute + chronic complications, respectively. Total and individual costs were significantly less for patients without complications than for those with the two types of complications (p < 0.001). (3) Mean total costs per patient were US$225.40 ± 115.32 (median: US$200.34), US$221.25 ± 177.64 (median: US$170.05), and US$275.18 ± 193.14 (median: US$217.91) for inpatients with microvascular complications, macrovascular complications, and microvascular + macrovascular complications, respectively. Total costs were significantly higher for patients with microvascular + macrovascular complications than for those with other types of chronic complications (p < 0.001). (4) Drugs were the greatest expense for patients, and the least expensive treatment was nursing care.ConclusionsMedical insurance status, age, and type of complication may help to predict LOS for patients with type 2 diabetes in Hubei Province, China. The total and individual costs for patients with complications were higher than for those without, and hospitalization expenses posed a heavy burden. Efforts should be made to reduce the financial impact on patients by integrating the medical insurance system of urban and rural areas, and by reducing the risk of complications, especially microvascular complications.
Highlights
The incidence of type 2 diabetes is increasing, creating a huge burden for China’s social healthcare system
Efforts should be made to reduce the financial impact on patients by integrating the medical insurance system of urban and rural areas, and by reducing the risk of complications, especially microvascular complications
Data on inpatients between April 1, 2013, and March 31, 2014, whose principal discharge diagnosis was type 2 diabetes were obtained from the hospital information system (HIS), with diagnosis of type 2 diabetes determined in accordance with World Health Organization guidelines [13]
Summary
The incidence of type 2 diabetes is increasing, creating a huge burden for China’s social healthcare system. Urbanization, and modernization, the number of people afflicted with type 2 diabetes is growing year by year, with a projected increase from current estimates of 240 million, 6% of adults, affected to some 380 million, or 7% of adults, by 2025 [1]. According to data from the International Diabetes Federation, between 2010 and 2030, there will be a 69% increase in numbers of adults with diabetes in developing countries, with 36% of the anticipated total global increase of 154 million people with diabetes projected to occur in India and China alone [2]. According to an epidemiological study of diabetes in China, the age-standardized prevalence of total diabetes and prediabetes were 9.7 and 15.5%, respectively, accounting for 92.4 million adults with diabetes and 148.2 million adults with prediabetes [7]
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