Excess hospitalizations, hospital days, and inpatient costs among people with diabetes in Andalusia, Spain.
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.


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 euro. 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 euro), 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 >or=45 years, cardiovascular complications were clearly the most important factor determining increased costs from diabetes.
Olveira-Fuster
Gabriel
G
Endocrinology and Nutrition Service, Carlos Haya Universitary Hospital, Malaga, Spain. gabrielm.olveira.sspa@juntadeandalucia.es
Olvera-Márquez
Pilar
P
Carral-Sanlaureano
Florentino
F
González-Romero
Stella
S
Aguilar-Diosdado
Manuel
M
Soriguer-Escofet
Federico
F
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003920:Diabetes Mellitus / Q000191:economics*; D005260:Female; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D013030:Spain