Excess Hospitalizations, Hospital Days, and Inpatient Costs Among People With Diabetes in Andalusia, Spain

• Published in: Diabetes care Vol. 27; no. 8; pp. 1904 - 1909
• Main Authors: Gabriel Olveira-Fuster, Pilar Olvera-Márquez, Florentino Carral-Sanlaureano, Stella González-Romero, Manuel Aguilar-Diosdado, Federico Soriguer-Escofet
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-08-2004
• Subjects: Adolescent; Adult; Age Distribution; Aged; Associated diseases and complications; Biological and medical sciences; Cardiovascular diseases; Diabetes; Diabetes Mellitus - economics; Diabetes. Impaired glucose tolerance; Economy. Management; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Health and social institutions; Hospital costs; Hospitalization; Hospitalization - economics; Hospitalization - statistics & numerical data; Humans; Length of Stay - economics; Male; Medical sciences; Middle Aged; Patient admissions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Spain; Europe; Spain; United States; Andalusia Spain; Endocrinopathy; Human; Costs; Diabetes mellitus; Health economy; Hospitalization; Economic aspect; Day hospital; Public health
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.27.8.1904

Excess Hospitalizations, Hospital Days, and Inpatient Costs Among People With Diabetes in Andalusia, Spain
Gabriel Olveira-Fuster , MD 1 ,
Pilar Olvera-Márquez , MD 1 ,
Florentino Carral-Sanlaureano , MD 2 ,
Stella González-Romero , MD 1 ,
Manuel Aguilar-Diosdado , MD 2 and
Federico Soriguer-Escofet , MD 1
1 Endocrinology and Nutrition Service, Carlos Haya Universitary Hospital, Malaga, Spain; and the
2 Endocrinology and Nutrition Service, Puerta del Mar Universitary Hospital, Cadiz, Spain
Address correspondence and reprint requests to Gabriel Olveira-Fuster Unidad de Nutrición, 4 a planta, Pabellón A Hospital Carlos Haya Avenida Carlos Haya s/n, Malaga 29010, Spain. E-mail: gabrielm.olveira.sspa{at}juntadeandalucia.es
Abstract
OBJECTIVE —The goal of this study was to estimate the excess hospitalizations, hospital days, and inpatient costs attributable to diabetes
in Andalusia, Spain (37 hospitals, 7,236,459 inhabitants), during 1999 compared with those without diabetes.
RESEARCH DESIGN AND METHODS —This study was an analysis of all hospital discharges. Those with an ICD-9-CM code of 250 as either the main or secondary
diagnosis were considered to have been admissions of individuals with diabetes. An estimate of costs was applied to each inpatient
admission by assigning a cost weight based on the diagnostic-related group (DRG) related to each admission.
RESULTS —A total of 538,580 admissions generated 4,310,654 hospital bed-days and total costs of €940,026,949. People with diabetes
accounted for 9.7% of all hospital discharges, 13.8% of total stays, and 14.1% of the total cost. Of the total cost for individuals
with diabetes (€132,509,217), 58.3% were excess costs, of which 47% was attributable to cardiovascular complications and 43%
to admissions for comorbid diseases. Individuals 45–75 years of age accounted for 75% of the excess costs. The rate of admissions
during the study year was 145 per 1,000 inhabitants for individuals with diabetes compared with 70 admissions per 1,000 inhabitants
for individuals without diabetes.
CONCLUSIONS —The costs arising from hospitalization of individuals with diabetes are disproportionate in relation to their prevalence.
For those aged ≥45 years, cardiovascular complications were clearly the most important factor determining increased costs
from diabetes.
DRG, diagnostic-related group
Footnotes
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
Accepted May 5, 2004.
Received December 2, 2003.
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