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 characterize the resource utilization and due direct costs required to manage these hypoglycemic events. The study included 18 centers in Portugal from November 2016 to August 2018. Patient level data and resource utilization were collected and then it was applied a micro-costing analysis, identifying and quantifying each resource and multiplying it by the corresponding cost. The direct costs included the medical costs (drugs, lab tests, exams and healthcare professional fees) and non-medical costs (bed occupancy cost). On average, physician and nurse attendance related cost per episode was 268.5€ and 673.4 €, respectively. Therefore, total cost regarding attendance by health professionals per episode averaged 941.94 € (range:55.09 - 9688.4€). The majority (92%) of the patients had a cost associated with medications administered during inpatient stay, which by episode averaged 45.45€ and had a maximum of 704.58 €. The great majority of the patients (98.7%; n=174) had an associated cost regarding laboratory analyses during hospitalization, which averaged 220.65€ and had a maximum of 1720.43 €. About 78% (n=138) of the patients had an associated cost regarding exams during hospitalization, which averaged 64.91€ per episode and had a maximum of 355.17 €. The mean standardized occupancy cost was 772.09 € per episode and had a maximum of 5,708.56 €. The overall direct cost per episode was, on average, 2,042.52€ (standard deviation: 2,151.84€; range: 94.76-16,762.87€). The resource utilization and the direct costs related with the management of hypoglycemia represents an economic burden for public hospitals of the National Health System.
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