The financial costs of hospital care for people with diabetes who have single and multiple macrovascular complications

Aim: To evaluate the impact on hospital costs of patients being diagnosed with multiple complications of diabetes. Methods: All inpatient admissions and outpatient appointments from the Cardiff and Vale of Glamorgan area (1996 onwards) were cross-referenced to the diabetes register. Each episode of inpatient care was coded using Healthcare Resource Group (HRG) grouper software. The allocated HRG-coded episode was linked to a series of elective and emergency reference costs from the National Health Service costing manual. Outpatient appointments were cost-coded using the mean reference costs by specialty. Non-psychiatric finished consultant episodes (FCEs) were used rather than admissions to report inpatient utilisation. Results: Overall, 2815 of the total 10,287 patients identified as inpatients had at least one admission; 6133 admissions (finished consultant episodes) were successfully grouped to give a total estimated cost of pound7,373,539. An incremental, linear relationship was observed in the cost increases for each additional diagnosed complication. Mean annual inpatient age-standardised costs were pound434 for no complications, pound999 for one complication, pound1,641 for two, and pound2,462 for three. There were 5717 patients with diabetes who attended 25,334 outpatient appointments. The estimated cost for these outpatient appointments was pound1,833,232. Conclusion: Minimising the number of complications in patients with diabetes would result in considerable cost offsets. (C) 2004 Elsevier Ireland Ltd. All rights reserved.