Kim Gyuri, Lee Yong-Ho, Han Mi Hye, Lee Eui-Kyung, Kim Chong Hwa, Kwon Hyuk Sang, Jeong In Kyung, Kang Eun Seok, Kim Dae Jung
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea.
PLoS One. 2016 Mar 14;11(3):e0151282. doi: 10.1371/journal.pone.0151282. eCollection 2016.
Hypoglycemia is a very serious complication in patients with type 2 diabetes mellitus (T2DM) and affects the economic burden of treatment. This study aims to create models of the cost of treating hypoglycemia in patients with T2DM based upon physician estimates of medical resource usage.
Using a literature review and personal advice from endocrinologists and emergency physicians, we developed several models for managing patients with hypoglycemia. The final model was approved by the consulting experts. We also developed 3 unique surveys to allow endocrinologists, emergency room (ER) physicians, and primary care physicians to evaluate the resource usage of patients with hypoglycemia. Medical costs were calculated by multiplying the estimated medical resource usage by the corresponding health insurance medical care costs reported in 2014.
In total, 40 endocrinologists, 20 ER physicians, and 30 primary care physicians completed the survey. We identified 12 types of standard medical models for secondary or tertiary hospitals and 4 for primary care clinics based on the use of ER, general ward, or intensive care unit (ICU) and patients' status of consciousness and self-respiration. Estimated medical costs per person per hypoglycemic event ranged from $17.28 to $1,857.09 for secondary and tertiary hospitals. These costs were higher for patients who were unconscious and for those requiring ICU admission.
Hypoglycemia has a substantial impact on the medical costs and its prevention will result in economic benefits for T2DM patients and society.
低血糖是2型糖尿病(T2DM)患者非常严重的并发症,会影响治疗的经济负担。本研究旨在根据医生对医疗资源使用情况的估计,建立T2DM患者低血糖治疗成本模型。
通过文献综述以及内分泌科医生和急诊科医生的个人建议,我们开发了几种低血糖患者管理模型。最终模型得到了咨询专家的认可。我们还开展了3项独特的调查,以便内分泌科医生、急诊室(ER)医生和初级保健医生评估低血糖患者的资源使用情况。医疗成本通过将估计的医疗资源使用量乘以2014年报告的相应医疗保险医疗费用来计算。
共有40名内分泌科医生、20名急诊室医生和30名初级保健医生完成了调查。根据急诊室、普通病房或重症监护病房(ICU)的使用情况以及患者的意识状态和自主呼吸情况,我们确定了二级或三级医院的12种标准医疗模型和初级保健诊所的4种标准医疗模型。二级和三级医院每次低血糖事件的人均估计医疗成本在17.28美元至1857.09美元之间。对于昏迷患者和需要入住ICU的患者,这些成本更高。
低血糖对医疗成本有重大影响,预防低血糖将为T2DM患者和社会带来经济效益。