Estimating and Examining the Costs of Inpatient Diabetes Care in an Irish Public Hospital.

AIM To estimate and examine hospitalisation costs of Type 1 and Type 2 diabetes in an Irish public hospital. METHODS A retrospective audit of hospital inpatient admissions over a five-year period was undertaken, and a wide range of admission-related data were collected for a sample of 7,548 admissions. Hospitalisations were costed using the diagnosis related group methodology. A series of descriptive, univariate and multivariate regression analyses were undertaken. RESULTS The mean hospitalisation cost for Type 1 diabetes was €4,027 and for Type 2 diabetes was €5,026 per admission. Sex, admission type and length of stay were significantly associated with hospitalisation costs for admissions with a primary diagnosis of Type 1 diabetes. Age, admission type, diagnosis status, complications status, discharge destination, length of stay and year were significantly associated with hospitalisation costs for admissions with a primary diagnosis of Type 2 diabetes. Length of stay was associated with higher mean costs, with each additional day increasing Type 1 diabetes costs by €260 (p=0.001) and Type 2 diabetes by €216 (p<0.001). Unscheduled admissions were associated with significantly lower costs than elective admissions; €1,578 (p=0.035) lower for Type 1 diabetes and €2,108 (p<0.001) lower for Type 2 diabetes. CONCLUSIONS This study presents estimates of the costs of diabetes care in the Irish public hospital system and identifies the factors which influence costs for Type 1 and Type 2 diabetes. These findings may be of interest to patients, the public, researchers, and those with influence over diabetes policy and practice in Ireland and internationally.