X Colin1, A Lafuma, B Gueron. 1. Cemka-Eval, 43 Boulevard du Maréchal Joffre, 92340 Bourg-la-reine, France. xavier.colin@cemka.fr
Abstract
AIMS: To test the assumption that hospital management of macro-vascular complications of Diabetes is more resource consuming in diabetic than in non-diabetic patients and to estimate, if relevant, the extra costs for diabetic patients. METHODS: The French national DRG database (PMSI- 2003) was analysed for the following cardio-vascular events (CVE): Stroke, Myocardial Infarction, Unstable Angina, Cardiac Arrest and Coronary Revascularization. Diabetic patients (Type 1 and 2) were identified using co-morbidity diagnosis. Differences in various indicators of resource consumption were tested between diabetic and non-diabetic patients. Using length of stay (LOS) as a cost driver, the extra hospital costs of each CVE were then estimated by reference to mean costs measured on the whole database. RESULTS: Average LOS of patients with diabetes were significantly longer than of non diabetic patients. (stroke: +2.5 days, myocardial infarction: +1.5 days, unstable angina: +1.3 days, revascularisation: +2.8 days; P<0.001). The mean numbers of medical procedures by stay were also higher in the diabetic group. Extra hospital costs of CVE for diabetic patients as compared with mean costs were the following: +23.9% (non fatal stroke), +10.4% (non fatal myocardial infarction), +6.1% (unstable angina), +9.1% (coronary revascularization). CONCLUSION: The hospital costs of CVE in diabetic patients are higher than average. Specific costs for these complications should be used to improve the relevance of economic studies of Diabetes.
AIMS: To test the assumption that hospital management of macro-vascular complications of Diabetes is more resource consuming in diabetic than in non-diabeticpatients and to estimate, if relevant, the extra costs for diabeticpatients. METHODS: The French national DRG database (PMSI- 2003) was analysed for the following cardio-vascular events (CVE): Stroke, Myocardial Infarction, Unstable Angina, Cardiac Arrest and Coronary Revascularization. Diabeticpatients (Type 1 and 2) were identified using co-morbidity diagnosis. Differences in various indicators of resource consumption were tested between diabetic and non-diabeticpatients. Using length of stay (LOS) as a cost driver, the extra hospital costs of each CVE were then estimated by reference to mean costs measured on the whole database. RESULTS: Average LOS of patients with diabetes were significantly longer than of non diabeticpatients. (stroke: +2.5 days, myocardial infarction: +1.5 days, unstable angina: +1.3 days, revascularisation: +2.8 days; P<0.001). The mean numbers of medical procedures by stay were also higher in the diabetic group. Extra hospital costs of CVE for diabeticpatients as compared with mean costs were the following: +23.9% (non fatal stroke), +10.4% (non fatal myocardial infarction), +6.1% (unstable angina), +9.1% (coronary revascularization). CONCLUSION: The hospital costs of CVE in diabeticpatients are higher than average. Specific costs for these complications should be used to improve the relevance of economic studies of Diabetes.