Tharkar Shabana, Satyavani Kumpatla, Viswanathan Vijay
MV Hospital for Diabetes and Diabetes Research Centre (WHO Collaborating Centre for Research, Education and Training in diabetes) No-4, Royapuram, Chennai 13, India.
Diabetes Res Clin Pract. 2009 Feb;83(2):263-7. doi: 10.1016/j.diabres.2008.11.027. Epub 2008 Dec 31.
The aim was to estimate the cost of medical care among hospitalized diabetic patients and to assess the influence of an additional co-morbid condition-hypertension. A pre tested and validated questionnaire was interviewer administered among 443 (male:female, 235:208) hospitalized diabetic patients. The JNC VII criteria for hypertension was considered to divide the study population into two groups; group I - diabetic patients without hypertension (n=269) and group II - diabetic patients with hypertension (n=174). Details of cost of inpatient and out-patient care and expenditure on hospitalization for the previous 2 years were obtained. The prevalence of hypertension among the study subjects was 39.3% (174 subjects). Presence of hypertension made a significant impact on the expenditure pattern. On an average a diabetic patient with hypertension spent 1.4 times more than a diabetic subject without hypertension. Median cost per hospitalization, length of stay during admission, and cost of 2 years for inpatient admission were all significantly higher for diabetic patients with a co-morbid condition. There is a need to develop a protocol on cost effective strategy for diabetes care. Strict control of hypertension should be targeted to avoid excess treatment cost on diabetes care.
目的是估算住院糖尿病患者的医疗费用,并评估另一种合并症——高血压的影响。在443名(男:女,235:208)住院糖尿病患者中,由访员管理一份经过预测试和验证的问卷。采用美国国家联合委员会第七版高血压标准将研究人群分为两组;第一组——无高血压的糖尿病患者(n = 269)和第二组——有高血压的糖尿病患者(n = 174)。获取了住院和门诊护理费用以及前两年住院支出的详细信息。研究对象中高血压的患病率为39.3%(174名受试者)。高血压的存在对支出模式产生了重大影响。平均而言,患有高血压的糖尿病患者的花费是没有高血压的糖尿病患者的1.4倍。合并症糖尿病患者每次住院的中位数费用、住院期间的住院时长以及两年的住院费用均显著更高。有必要制定一项关于糖尿病护理成本效益策略的方案。应针对严格控制高血压,以避免糖尿病护理方面的过度治疗费用。