Estimating and examining the costs of inpatient diabetes care in an Irish Public Hospital

Aim To estimate and examine hospitalisation costs of Type 1 and Type 2 diabetes in an Irish public hospital. Methods A retrospective audit of hospital inpatient admissions over a 5-year period was undertaken, and a wide range of admission-related data were collected for a sample of 7,548 admissions. Hospitalisations were costed using the diagnosis-related group methodology. A series of descriptive, univariate and multivariate regression analyses were undertaken. Results The mean hospitalisation cost for Type 1 diabetes was euro4,027 and for Type 2 diabetes was euro5,026 per admission. Sex, admission type and length of stay were significantly associated with hospitalisation costs for admissions with a primary diagnosis of Type 1 diabetes. Age, admission type, diagnosis status, complications status, discharge destination, length of stay and year were significantly associated with hospitalisation costs for admissions with a primary diagnosis of Type 2 diabetes. Length of stay was associated with higher mean costs, with each additional day increasing Type 1 diabetes costs by euro260 (p = 0.001) and Type 2 diabetes by euro216 (p < 0.001). Unscheduled admissions were associated with significantly lower costs than elective admissions; euro1,578 (p = 0.035) lower for Type 1 diabetes and euro2,108 (p < 0.001) lower for Type 2 diabetes. Conclusions This study presents estimates of the costs of diabetes care in the Irish public hospital system and identifies the factors which influence costs for Type 1 and Type 2 diabetes. These findings may be of interest to patients, the public, researchers and those with influence over diabetes policy and practice in Ireland and internationally.