Hospitalization Among Diabetic Children and Adolescents and the General Population in Germany

Abstract

OBJECTIVE—To compare hospitalization in a multicenter-based cohort of diabetic children and adolescents (aged 1–19 years) in Germany with that of the general population. RESEARCH DESIGN AND METHODS—Based on standardized documentation, hospital stays after manifestation were ascertained in diabetic subjects 1–19 years of age in 1997. Hospitalization data in the general German population were derived from official statistics. Incidence rates and numbers of hospital days were estimated. Ratios of hospitalization incidences and numbers of hospital days between the diabetic and the general population were calculated. Costs for hospital care in the German diabetic population in 1997 were determined. RESULTS—A total of 5,874 patients came from 61 pediatric centers (52% male, age [mean ± SD] 12.2 ± 4.3 years, diabetes duration 4.6 ± 4.4 years). Hospitalization incidence rates and hospital days per person-year (95% CI) were 0.27 (0.25–0.29) and 1.80 (1.75–1.84) in the diabetic population and 0.0948 (0.0946–0.0949) and 0.6416 (0.6412–0.6420) in the general population. The standardized ratio of hospital incidences was 3.1 (2.9–3.2), and the ratio of numbers of hospital days was 2.8 (2.7–2.9). Costs for hospital care after manifestation were estimated to be $506 (U.S. dollars) per person-year and $12.4 million in the whole German diabetic population aged 1–19 years in 1997; including hospital stays at diabetes onset, total annual costs were $24 million ($970 per person-year). CONCLUSIONS—Diabetic children and adolescents in Germany had an approximately three times higher hospitalization risk and three times more hospital days than the age-matched general population. Including hospitalization at diabetes onset, the annual costs of hospital care for the German diabetic population aged 1–19 years amounted to ∼1% of all costs for hospital care in this age-group. Thus, costs were largely overproportional (diabetes prevalence 0.1%).