Counting the cost of diabetic hospital admissions in North Trinidad - abstract

ABSTRACT

A register was compiled of all patients with diabetes mellitus who were admitted to medical, general surgical or opthalmology wards at the Port-of-Spain General Hospital over a 26-week period form October, 1993 to April, 1994. Admission rates declined with increasing distance from the hospital, but increased with age, were higher in women than in men, and higher in Indo-Trinidadians than in Afro-Trinidadians. There were 1722 diabetic admissions of whom 1334 (77 percent) were medical, 302 (18 percent) surgical and 86 (5 percent) opthalmology. Frequent diagnoses on admission were hyperglycaemia, 19 percent; hypoglycaemia, 12 percent; stroke and myocardial infarction, 8 percent each. The median length of stay was 4 days (interquartile range, 2 to 9 days). Diabetic inpatients occupied an estimated 26,659 hospital bed days per year, with an estimated hospital cost > TT$10.6 million (US$1.8 million). Patients admitted with disorders of glycaemic control or foot problems occupied an estimated 13,913 bed days per year with an approximate annual cost of TT$5.5 million (US$0.96 million). The mean cost of one diabetic admission was approximately TT$3,096 (US$538). This sum would cover the cost of one year's treatment in a government primary care setting for up to 9 persons with diabetes mellitus. Many admissions might be avoided with improved preventive management in primary health care settings. Improving the quality of primary care for diabetes mellitus might free considerable hospital resources for alternative use (AU)