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Patterns of hospitalisation in a paediatric diabetes clinic in Sydney
D L Sutton1, P Greenacre, N J Howard
1Institute of Endocrinology, Children's Hospital, Camperdown, New South Wales, Australia.
Insights
Hospital admissions for childhood diabetes are frequent and costly, with most cases of poor control being preventable. This study highlights the significant morbidity and economic burden of pediatric diabetes, emphasizing the need for better management strategies.
Area of Science:
- Pediatrics
- Endocrinology
- Health Economics
Background:
- Childhood diabetes (specifically Type 1 Diabetes Mellitus) leads to significant hospitalizations.
- Understanding the patterns and costs associated with pediatric diabetes admissions is crucial for resource allocation and preventative care.
Purpose of the Study:
- To analyze the demographics, duration, reasons, and costs of hospital admissions for children with diabetes.
- To assess the preventability of diabetes-related hospitalizations in pediatric patients.
Main Methods:
- Retrospective review of hospital records for children admitted with diabetes between 1985-1987.
- Calculation of direct costs per bed-day and per admission.
- Comparison of diabetes admission rates with population prevalence.
Main Results:
- Median admission duration was 12 days for new diagnoses and 7 days for subsequent admissions.
- Diabetes accounted for a disproportionately high number of admissions compared to its prevalence.
- 5.5% of registered diabetic patients aged 0-19 were hospitalized, primarily for poor control; the 10-14 age group was most at risk for ketoacidosis.
- Costs: $Aust 295 per diabetic bed-day, $Aust 3660 for initial diagnosis admission, and $Aust 2680 for subsequent admissions.
Conclusions:
- Pediatric diabetes results in substantial hospital morbidity and economic burden.
- A significant proportion of diabetes-related hospital admissions, particularly those for poor control, are preventable.
- Improved diabetes management in children could reduce hospitalizations and associated costs.
Abstract:
The hospital notes of all children with diabetes admitted to the Children's Hospital (both newly diagnosed and subsequent admissions) for the period 1985-1987 were examined. The information collected included basic demographic data, number of bed-days per admission, and reasons for admission. The direct cost of a bed-day and an admission for diabetes in this hospital were calculated. The median duration of an admission at diagnosis was 12 days, and of a subsequent admission 7 days. The proportion of total admissions to the Children's Hospital in 1987 which were due to diabetes (post diagnosis) was eight times the prevalence of IDDM in the 0-14-year population. In 1987, 5.5% of the diabetic patients (excluding new cases) aged 0-19 years and registered with this Diabetes Unit were admitted to hospital. Most of these admissions were for poor control, and were thus potentially preventable. The age group most at risk for admission due to ketoacidosis was the 10-14-year group. The cost of a diabetic bed-day was $Aust 295, average cost of an admission at diagnosis $Aust 3660, and of a post-diagnosis admission $Aust 2680. Thus, even in this young age group there is considerable morbidity due to diabetes, most of which can probably be prevented.