Economic burden of hypoglycemia for type II diabetes mellitus patients in Malaysia


Autoři: Syed Mohamed Aljunid aff001;  Yin Nwe Aung aff001;  Aniza Ismail aff001;  Siti Athirah Zafirah Abdul Rashid aff001;  Amrizal M. Nur aff001;  Julius Cheah aff004;  Priya Matzen aff004
Působiště autorů: International Centre for Casemix and Clinical Coding, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia aff001;  Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Hawalli, Kuwait aff002;  Department of Pathology and Community Medicine, Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia aff003;  Market Access and Public Affairs, Novo Nordisk Pharma (Malaysia) Sdn Bhd, Kuala Lumpur, Malaysia aff004;  Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Kuala Lumpur, Malaysia aff005;  Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom aff006
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0211248

Souhrn

This study mainly aims to identify the direct cost and economic burden of hypoglycemia for patients with type II diabetes mellitus in Malaysia. A cross-sectional study explored the cost incurred for hypoglycemia among patients admitted to University Kebangsaan Malaysia Medical Centre (UKMMC). The study covered patients aged 20–79 years hospitalized with a primary diagnosis of ICD-10 hypoglycemia and discharged between January 2010 and September 2015 according to the casemix database. A costing analysis was done through a step-down approach from the perspective of health providers. Cost data were collected for three levels of cost centers with the help of a hospital-costing template. The costing data from UKMMC were used to estimate the national burden of hypoglycemia among type II diabetics for the whole country. Of 244 diabetes patients admitted primarily for hypoglycemia to UKMMC, 52% were female and 88% were over 50 years old. The cost increased with severity. Managing a hypoglycemic case requires five days (median) of inpatient stay on average, with a range of 2–26 days, and costs RM 8,949 (USD 2,289). Of the total cost, 30% related to ward (final cost center), 16% to ICU, and 15% to pharmacy (secondary-level cost center) services. Considering that 3.2% of all admissions were hypoglycemia related, the total annual cost of hypoglycemia care for adult diabetics in Malaysia is estimated at RM 117.4 (USD 30.0) million, which translates to 0.5% of the Ministry of Health budget. Hypoglycemia imposes a substantial economic impact even without the direct and indirect cost incurred by patients and other cost of complications. Diabetic management needs to include proper diabetic care and health education to reduce episodes of hypoglycemia.

Klíčová slova:

Diabetes mellitus – Health economics – Hospitals – Hypoglycemia – Hypoglycemics – Inpatients – Insulin – Malaysia


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2019 Číslo 10