The financial costs of hospital care for people with diabetes who have single and multiple macrovascular complications.
OBJECTIVE
To evaluate the impact on hospital costs of patients being diagnosed with multiple complications of diabetes.


METHODS
All inpatient admissions and outpatient appointments from the Cardiff and Vale of Glamorgan area (1996 onwards) were cross-referenced to the diabetes register. Each episode of inpatient care was coded using Healthcare Resource Group (HRG) grouper software. The allocated HRG-coded episode was linked to a series of elective and emergency reference costs from the National Health Service costing manual. Outpatient appointments were cost-coded using the mean reference costs by specialty. Non-psychiatric finished consultant episodes (FCEs) were used rather than admissions to report inpatient utilisation.


RESULTS
Overall, 2815 of the total 10,287 patients identified as inpatients had at least one admission; 6133 admissions (finished consultant episodes) were successfully grouped to give a total estimated cost of pound sterling 7,373,539. An incremental, linear relationship was observed in the cost increases for each additional diagnosed complication. Mean annual inpatient age-standardised costs were pound sterling 434 for no complications, pound sterling 999 for one complication, pound sterling 1,641 for two, and pound sterling 2,462 for three. There were 5717 patients with diabetes who attended 25,334 outpatient appointments. The estimated cost for these outpatient appointments was pound sterling 1,833,232.


CONCLUSIONS
Minimising the number of complications in patients with diabetes would result in considerable cost offsets.
Currie
Craig J
CJ
Department of Medicine, University Hospital of Wales, Cardiff, Wales CF4 4UJ, UK. currie@cardiff.ac.uk
Morgan
Christopher Ll
CL
Dixon
Simon
S
McEwan
Phil
P
Marchant
Nick
N
Bearne
Andy
A
Sharplin
Peter
P
Peters
John R
JR
D000553:Ambulatory Care / Q000191:economics; D048909:Diabetes Complications / Q000191:economics / Q000628:therapy; D003920:Diabetes Mellitus / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000191:economics* / Q000628:therapy*; D004470:Economics, Medical; D017048:Health Care Costs; D017721:Hospital Costs; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013038:Specialization; D006113:United Kingdom