Economic Burden of Hypoglycaemia among Type II Diabetes Mellitus Patients in Malaysia

Abstract

AbstractObjectiveThe main aim of this study is to identify the direct cost and economic burden of hypoglycaemia among patients with Type II diabetes mellitus in Malaysia.MethodsThe incurred cost for hypoglycaemia among patients admitted to University Kebangsaan Malaysia Medical Centre (UKMMC) was explored from a cross sectional study. 20-79 year patients discharged between Jan 2010 to Sept 2015 and having an ICD-10 code of hypoglycaemia as a primary diagnosis in the casemix database were included in the study. Costing analysis from the perspective of health providers was completed using step-down approach. Data related to hospital cost were collected using hospital-costing template, based on three levels of cost centres. The costing data from UKMMC was used to estimate the national burden of hypoglycaemia among type II diabetics for the whole country.ResultsOf 244 diabetes patients admitted primarily for hypoglycaemia to UKMMC, 52% were female and 88% were over 50 years old. The cost increased with severity. Managing a hypoglycaemic case requires 5 days (median) of inpatient stay with a range of 2-26 days; and costs RM 9,083 (USD 2,323). 30% of the cost came from the ward services cost (final cost centre), 16% of the cost came from ICU services and 15% from pharmacy services(secondarylevel cost centres). Based on the prevalence of hypoglycaemia-related admissions of 3.2%, the total cost of care for hypoglycaemia among adult diabetes in Malaysia is estimated to be RM 117.4 (USD 30.0) million, which is translated as 0.5% of Ministry of Health budget.ConclusionHypoglycaemia imposes substantial economic impact even without the direct and indirect cost incurred by patients and other cost of complications. Proper diabetic care and health education is needed in diabetic management to reduce episodes of hypoglycaemia.