Comparative estimates of the financial burden to the UK health system of hospital care for people with and without diabetes in the year before death.
OBJECTIVE
To quantify hospital costs prior to death for patients with and without diabetes.


METHODS
Using the Cardiff Diabetes Database, mortality data from the UK Office of National Statistics for 1996 were linked to existing hospital records using probability matching techniques. Costs were attributed using a statistical costing technique (healthcare resource groups (HRGs)) with UK 2000 prices.


RESULTS
There were 4394 deaths of which 412 (9.4%) were for patients with diabetes. In the year before death 380 (92%) patients with diabetes (DM+) were admitted as an inpatient compared with 73% of those without diabetes (DM-), a relative rate of 1.27. Total inpatient costs were 12.2M UK pound sterling (20M US dollars) of which costs for patients with diabetes were 1.6M UK pound sterling (2.6M US dollars), accounting for 15.6% of revenue. This translates to a rate of 2.8M UK pound sterling (4.0M US dollars) per 100,000 population per year. The mean annual inpatient cost before death was UK pound 3997 (5676 US dollars) for DM+ compared with UK pound 2656 (3772 US dollars) for DM-. Mean annual outpatient costs ranged from 185 UK pound sterling (263 US dollars: year minus 4) to 248 UK pound sterling (352 US dollars: year minus 2) in DM+, and 91 UK pound sterling (129 US dollars: year minus 4) to 116 UK pound sterling (165 US dollars: year minus 2) in DM-. Mean annual outpatient costs associated with the care of people with diabetes are consistently higher: +80% at minus 1-year rising to +120% at minus 3 years.


CONCLUSIONS
The costs of inpatient care for all patients increases markedly in the final year of life. People with diabetes were found to be more financially costly, even in this stage of their care, than were people who did not have diabetes.
Department of Diabetes, Endocrinology and Metabolism, University of Wales College of Medicine, Medicentre, Heath Park, Cardiff CF4 4UJ, Wales, UK. curriec@cardiff.ac.uk
Craig J
CJ
Currie
Christopher Ll
CL
Morgan
Simon
S
Dixon
Phil
P
McEwan
Nick
N
Marchant
Andy
A
Bearne
Peter
P
Sharplin
John R
JR
Peters
D003920:Diabetes Mellitus / Q000191:economics* / Q000401:mortality; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D013222:State Medicine / Q000191:economics*; D006113:United Kingdom