Abstract
The purpose was to compare the economic outcomes of HIPOS-WARD and HIPOS-ER on the management of hypoglycemic events in diabetic patients, considering different hospital settings. HIPOS-ER and HIPOS-WARD were observational, cross-sectional, multicenter and national studies, with different methodologies and populations, that aimed to evaluate the clinical and economic burden of hypoglycemic events in hospitalized diabetic patients or in type 2 diabetic patients admitted to an emergency room, respectively. Both studies adopted the societal perspective and used the patient-level data to quantify healthcare resource use and due costs required to manage these hypoglycemic events, including overall direct costs and indirect costs associated with productivity loss. In HIPOS-ER study, the overall cost per hypoglycemic episode averaged 1,493€ (standard deviation [SD]: 2,962€; range: 34 – 26,818€). Patients treated with secretagogues had the highest rates of hospitalizations and mean costs. Mean hospitalization cost was 1,271€ and indirect cost averaged 15€. In HIPOS-WARD the total cost associated with the hypoglycemic episode was, on average, 2,182.96€ (SD: 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. Indirect costs averaged 140.44€. Insulin based therapy and other types of diabetes were, on average, costlier per episode than the other. Even considering the different methodologies of both studies, it may be concluded that different hospital settings may influence the resource use and costs of managing the hypoglycemic events in diabetic patients. However, the combined analysis of HIPOS-WARD and HIPOS-ER shows the substantial economic burden of these events for the Society and for the Portuguese National Health System.
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