title: Incidence and care-related costs of severe hypoglycaemia requiring emergency treatment in Andalusia (Spain): the PAUEPAD project.
abstract: Hypoglycaemia is a serious medical emergency. The need for emergency medical service care and the costs of hypoglycaemic emergencies are not completely known.
  
  
  
  This was a retrospective observational study using Public Company for Health Emergencies (EPES) data for hypoglycaemia in 2012. The EPES provides emergency medical services to the entire population of Andalusia, Spain (8.5 million people). Data on event type, onsite treatments, emergency room visits or hospitalization were collected. Medical costs were estimated using the public rates for healthcare services.
  
  
  
  From a total of 1 137 738 emergency calls that requested medical assistance, 8683 had a primary diagnosis of hypoglycaemia (10.34 per 10 000 person-years). The incidence of severe hypoglycaemic episodes requiring emergency treatment in the estimated population with diabetes was 80 episodes per 10 000 person-years. A total of 7479 episodes (86%) required an emergency team to visit the patient's residence. The majority of cases (64%) were addressed in the residence, although 1784 (21%) cases were transferred to hospital. A total of 5564 events (65%) involved patients aged > 65 years. Overall mortality was 0.32% (28 cases). The total annual cost of attending a hypoglycaemic episode was €6 093 507, leading to an estimated mean direct cost per episode of €702 ± 565. Episodes that required hospital treatment accounted for 49% of the total costs.
  
  
  
  Hypoglycaemia is a common medical emergency that is associated with high emergency medical service utilization, resulting in a significant economic impact on the health system.
authors.affiliation: Public Company for Health Emergencies of Andalucıa (EPES), Sevilla, Spain.|Department Health Sciences, University of Jaen, Segovia, Spain.
authors.forename: R J
authors.initials: RJ
authors.lastname: Barranco
authors.affiliation: Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia, Spain.
authors.forename: F
authors.identifier: 0000-0003-0106-0091
authors.initials: F
authors.lastname: Gomez-Peralta
authors.affiliation: Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Abreu
authors.affiliation: Division of Preventive Medicine and Public Health, Department Health Sciences, University of Jaen, Jaen, Spain.|Center for Biomedical Research in Epidemiology and Public Health (CIBERESP), ISCIII, Ministry of Health, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Delgado
authors.affiliation: Endocrinology and Nutrition Unit, Reina Sofia Hospital, Cordoba, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Palomares
authors.affiliation: Public Company for Health Emergencies of Andalucıa (EPES), Sevilla, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Romero
authors.affiliation: Endocrinology and Nutrition Unit, Virgen Macarena Hospital, Sevilla, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Morales
authors.affiliation: Public Company for Health Emergencies of Andalucıa (EPES), Sevilla, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: de la Cal
authors.affiliation: Endocrinology and Clinical Nutrition Unit, Virgen de la Victoria Hospital, Malaga, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Garcia-Almeida
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: F
authors.initials: F
authors.lastname: Pasquel
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: G E
authors.initials: GE
authors.lastname: Umpierrez
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D048909:Diabetes Complications / Q000191:economics / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D004180:Direct Service Costs; D004632:Emergency Medical Services / Q000191:economics; D004636:Emergency Service, Hospital / Q000191:economics; D005260:Female; D006760:Hospitalization; D006801:Humans; D007003:Hypoglycemia / Q000191:economics / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D015994:Incidence; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology