Abstract: FR-PO316
Health Care Costs and Utilisation for Diabetes Mellitus among Hospitalised Patients in Ireland: The National Kidney Disease Surveillance System
Session Information
- Diabetic Kidney Disease: Clinical Modeling, Diagnosis, Education, and More
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Browne, Leonard, University of Limerick, Limerick, Limerick, Ireland
- Tandan, Meera, University of Limerick, Limerick, Limerick, Ireland
- Stack, Austin G., University of Limerick, Limerick, Limerick, Ireland
Group or Team Name
- National Kidney Disease Surveillance System and Quality Assurance Programme.
Background
A better understanding of the frequency, length of stay, and costs of inpatient hospitalisation for diabetes mellitus (DM) is crucial for effective national healthcare planning and resource allocation. We explored the rates of diabetes-related hospitalisations and associated healthcare costs in Ireland.
Methods
We utilised data from the National Hospital In-Patient Enquiry (HIPE) database in 2022, which captured all hospitalisations to public hospitals in Ireland. We included all ICD-10 hospital admissions with a principal or additional diagnosis of diabetes (E10, E11, E13, E14, O24). Age-standardised rates (ASR), length of stay, and costs were computed and compared across demographic characteristics, Charlson comorbidity score (0, 1-2, and ≥3), and 8 health regions. Rates were standardised to the European Standard Population from 2012, and rate ratios (RR) were determined and compared.
Results
In 2022, 8.6% of all hospitalisations in Ireland (146,362/1,711,564) recorded diabetes as a principal or additional diagnosis, costing €601 million. Diabetes as principal diagnosis accounted for 10,511 hospitalisations with the following breakdown: type 2 diabetes (58.5%), type 1 diabetes (28.4%) gestational diabetes (12.7%), and other or unspecified diabetes (0.2%). Average LOS was 4.9 days and increased significantly rising Charlson Comorbidity score (range 3.9 to 9.2 days). Hospital admissions, LOS, and costs increased significantly with increasing comorbidity burden. The most frequent complications were kidney, eye, and circulatory complications. Age standardised rates were higher in men than women (4,071 vs 2,844 per 100, 000 population) and men experienced significantly higher rates than women for kidney (x 1.9 times), eye (x1.8 times), circulatory (x3.6 times), and neurological complications (x1.9 times). Hospitalisation rates varied significantly by region: lowest in the Southwest RR 0.8 (0.8-0.8) and highest in the Midland region RR 1.8 (1.7-1.8) (P<0.01) compared to the national average (RR 1.00).
Conclusion
Diabetes mellitus contributes substantially to healthcare utilisation and costs in Ireland driven by complications related to kidney disease, eye disease and circulatory disease. Demographic and regional disparities exist and highlight the need for strategic healthcare planning and early preventive care.