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在英国治疗糖尿病酮症酸中毒的费用:一项全国性的医院资源利用调查。

The cost of treating diabetic ketoacidosis in the UK: a national survey of hospital resource use.

机构信息

Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust.

Health Economics Consulting, Norwich Medical School, University of East Anglia, Norwich, UK.

出版信息

Diabet Med. 2017 Oct;34(10):1361-1366. doi: 10.1111/dme.13427. Epub 2017 Aug 14.

Abstract

AIM

Diabetic ketoacidosis is a commonly encountered metabolic emergency. In 2014, a national survey was conducted looking at the management of diabetic ketoacidosis in adult patients across the UK. The survey reported the clinical management of individual patients as well as institutional factors that teams felt were important in helping to deliver that care. However, the costs of treating diabetic ketoacidosis were not reported.

METHODS

We used a 'bottom up' approach to cost analysis to determine the total expense associated with treating diabetic ketoacidosis in a mixed population sample. The data were derived from the source data from the national UK survey of 283 individual patients collected via questionnaires sent to hospitals across the country.

RESULTS

Because the initial survey collection tool was not designed with a health economic model in mind, several assumptions were made when analysing the data. The mean and median time in hospital was 5.6 and 2.7 days respectively. Based on the individual patient data and using the Joint British Diabetes Societies Inpatient Care Group guidelines, the cost analysis shows that for this cohort, the average cost for an episode of diabetic ketoacidosis was £2064 per patient (95% confidence intervals: 1800, 2563).

CONCLUSION

Despite relatively short stays in hospital, costs for managing episodes of diabetic ketoacidosis in adults were relatively high. Assumptions made in the calculations did not consider prolonged hospital stay due to comorbidities or costs incurred as a loss of productivity. Therefore, the actual costs to the healthcare system and society in general are likely to be substantially higher.

摘要

目的

糖尿病酮症酸中毒是一种常见的代谢急症。2014 年,英国进行了一项全国性调查,调查了英国各地成年糖尿病酮症酸中毒患者的管理情况。该调查报告了对个别患者的临床管理以及团队认为有助于提供护理的机构因素。然而,并未报告治疗糖尿病酮症酸中毒的费用。

方法

我们采用“自下而上”的成本分析方法来确定治疗混合人群中糖尿病酮症酸中毒的总费用。数据来源于全国范围内 283 名患者的问卷调查,这些数据来自于全国各医院的问卷调查。

结果

由于最初的调查收集工具没有考虑到卫生经济学模型,因此在分析数据时做了一些假设。住院的平均和中位数时间分别为 5.6 天和 2.7 天。根据患者个体数据,并使用联合英国糖尿病协会住院患者护理组指南,成本分析显示,对于这组患者,每例糖尿病酮症酸中毒的平均费用为 2064 英镑(95%置信区间:1800,2563)。

结论

尽管住院时间相对较短,但成年人管理糖尿病酮症酸中毒的费用相对较高。计算中所做的假设并未考虑因合并症而延长住院时间或因生产力损失而产生的费用。因此,医疗系统和整个社会的实际成本可能要高得多。

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