National Institute for Health Research School for Primary Care Health Sciences, Department of Primary Health Care, University of Oxford, Oxford, UK.
Diabet Med. 2012 Nov;29(11):1447-50. doi: 10.1111/j.1464-5491.2012.03657.x.
The aim was to estimate the incidence of severe hypoglycaemia requiring emergency ambulance assistance, its management and associated costs.
A retrospective observational study used routinely collected data for a 1-year period from December 2009 to November 2010 from the South Central Ambulance Service National Health Service Trust, UK. The main outcome was episodes reported by ambulance personnel and costs were estimated from published data.
During the 1-year study period, 398,409 emergency calls were received, of which 4081 (1.02%) were coded as hypoglycaemia. The overall numbers (and annual rate) of hypoglycaemia recorded among people ≥ 15 years with presumed diabetes was 3962 (2.1%), but for those aged 15-35 years was 516 (7.5%) and for those aged ≥ 65 years was 1886 (1.9%). Of those attended, 1441 (35.3%) were taken to hospital. The estimated total cost of initial ambulance attendance and treatment at scene was £553,000; if transport to hospital was necessary, the additional ambulance costs were £223,000 plus emergency department costs of £140,000; and the cost of primary care follow-up was estimated as £61,000. The average cost per emergency call was £263. The estimated annual cost of emergency calls for severe hypoglycaemia is £13.6m for England.
Our estimates suggest prevalence of severe hypoglycaemia attended by the emergency services is high in younger age groups and lower for older age groups, although the absolute numbers of severe events in older age groups contribute substantially to the overall costs of providing emergency assistance for hypoglycaemia.
评估需要紧急救护车援助的严重低血糖症的发生率、管理和相关费用。
采用回顾性观察研究方法，使用 2009 年 12 月至 2010 年 11 月英国南中急救服务国民保健信托基金的常规收集数据，进行为期 1 年的研究。主要结局指标为救护车人员报告的发作事件，费用则根据已发表的数据进行估计。
在 1 年的研究期间，共收到 398409 次紧急呼叫，其中 4081 次（1.02%）被编码为低血糖症。在≥15 岁且推测患有糖尿病的人群中，低血糖症的记录总数（及年发生率）为 3962 例（2.1%），但 15-35 岁人群为 516 例（7.5%），≥65 岁人群为 1886 例（1.9%）。在接受治疗的患者中，有 1441 例（35.3%）被送往医院。最初的救护车出勤和现场治疗的估计总成本为 553000 英镑；如果需要转往医院，则额外的救护车费用为 223000 英镑，外加急诊科费用 140000 英镑；初级保健随访的费用估计为 61000 英镑。每个紧急呼叫的平均费用为 263 英镑。估计英格兰因严重低血糖症而拨打的紧急电话的年费用为 1360 万英镑。
我们的估计表明，年轻人群中因严重低血糖症而由急救服务机构处理的情况高发，而老年人群中则较低，尽管老年人群中严重事件的绝对数量对低血糖症紧急援助提供的总成本有很大的影响。
