Abstract

HIPOS-WARD was an observational, cross-sectional, multicenter study designed to evaluate diabetic patients hospitalized due to a hypoglycemic episode as a function of the diabetic patients hospitalized due to a hyperglycemic emergency. A key secondary objective was to estimate the total costs associated with the management of the mentioned hypoglycemic events. The study was conducted in 18 centers in Portugal for a period of 21 months (Nov 2017-Aug2018). Patient level data and resource utilization were collected. The study followed the societal perspective as it considered both direct and indirect costs related with the hypoglycemic events. Average direct costs were assessed by multiplying unit costs, available from public sources, with all relevant healthcare resource consumption items registered in the management of these patients. Indirect costs were applicable only to active workers, full or partial and its estimates followed the Human Capital Approach. Regarding the distribution of the total cost by components, standardized occupancy cost was the main driver representing 35% of the total cost per episode. Time spent by healthcare professionals represented 43% of the total cost, laboratory tests and other exams added represented 13%, drugs represented 2% and productivity loss represented 6%. Total cost associated with the episode, including both the direct and indirect cost was, on average, 2,182.96€ (Standard Deviation: 2,289.62€; range: 194.76€ - 16,762.87€). The time spent by healthcare professionals and the occupancy costs represented almost 80% of the total cost per episode. Insulin based therapy and other types of diabetes are, on average, costlier per episode than the other. Hypoglycemic events represent an important economic burden for the society and in particular for the public hospitals of the National Health System.

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