Comparative hospitalization cost and length of stay between patients with and without diabetes in a large tertiary hospital in Johannesburg, South Africa

Abstract

The study compared the costs and length of hospitalization between patients with diabetes and patients without diabetes for a cross-section of patients (N = 407) discharged with cerebrovascular diseases, ophthalmic conditions, cardiovascular diseases, renal conditions, neurological diseases, and peripheral vascular diseases. A cross-sectional retrospective audit of medical records of all patients discharged from a Tertiary Hospital in Johannesburg with those conditions in December 2009 was conducted. Patients were grouped by ICD-10 codes from the hospital’s database. Medical records were analyzed to determine, the diabetes status of the patients, laboratory tests conducted, medical procedures performed, drugs prescribed, and frequency of hospitalization during the 2009 admission period. Average total hospitalization costs per patient were significantly higher for the patients with diabetes cohorts; R27,216 ± R19,476 compared to R18,185 ± R16,726 for the patients without diabetes, (P < 0.00001). The average length of stay for patients with diabetes was longer, 13.04 ± 9.29 days vs. 8.86 ± 8.33 days (P < 0.00001) than for patients without diabetes. Average admission rate per patient per year in 2009 was higher in the patients with diabetes; 1.8 ± 0.8 times vs. 1.5 ± 0.6 times than in patients without diabetes, (P < 0.00004). Results should be used to advocate for improved diabetes prevention awareness, improved patient understanding of the reasons for strict diabetes control measures, and keen attendance in out-patient clinics to avoid unnecessary hospitalization costs.