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Updated: Jan 15, 2026
A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
Routine hemoglobin-A1c screening is required before the next pandemic to reduce morbidity and in-hospital costs
Yasemin Saygideger1, Aslihan Candevir2, Bengu Curuk1
1Department of Pulmonary, School of Medicine, Cukurova University, Adana, Turkey.
Insights
High glycosylated hemoglobin (HbA1c) levels in hospitalized patients correlate with increased in-hospital costs and mortality. Routine HbA1c testing in primary care could be cost-effective for diabetes management.
Area of Science:
- Endocrinology
- Healthcare Economics
- Public Health
Background:
- Glycosylated hemoglobin (HbA1c) monitoring is crucial for diabetes management but often limited to specialized care due to cost.
- The COVID-19 pandemic highlighted the need for efficient healthcare resource allocation and preparedness.
- Understanding the economic impact of glycemic control is vital for public health strategies.
Purpose of the Study:
- To investigate the association between HbA1c levels and in-hospital costs during the pandemic.
- To evaluate HbA1c as a predictor of healthcare costs and patient outcomes.
- To inform policy regarding HbA1c testing in primary care settings.
Main Methods:
- Retrospective, cross-sectional study design.
- Analysis of data from 517 hospitalized patients (March-December 2020).
- Statistical correlation of HbA1c levels with in-hospital costs, prolonged stays (≥ 14 days), and 30-day mortality.
Main Results:
- Patients with HbA1c ≥ 7% exhibited significantly higher in-hospital costs.
- Elevated HbA1c (≥ 7%) was a stronger predictor of costs than a diabetes diagnosis.
- High HbA1c levels were associated with prolonged hospital stays and increased mortality rates.
Conclusions:
- Routine HbA1c testing, even in primary care, may prove cost-effective.
- Implementing widespread HbA1c screening can improve patient outcomes and resource management.
- This approach supports better preparedness for future health crises.
Introduction:
Glycosylated hemoglobin (HbA1c) levels are routinely used in secondary and tertiary care centers for monitoring diabetes patients. However, since it is an expensive test, it is not routinely tested in primary care or used as a screening test. This study aimed to examine the relationship between HbA1c levels and in-hospital costs in hospitalized patients during the pandemic period to draw attention to the issue and to be prepared for future pandemics.
Methodology:
The design of the study was retrospective and cross-sectional. The study was conducted in a tertiary hospital between March and December 2020. Independent variables, including HbA1c levels, comorbidities, age, and gender; and dependent variables including in-hospital costs, prolonged hospital stay (≥ 14 days), and 30-day mortality; were statistically analyzed.
Results:
Overall, 517 patients were included in the study, and 96 of them had high HbA1c levels (HbA1c ≥ 7). The in-hospital costs were significantly correlated with HbA1c ≥ 7 as continuous variables, and HbA1c ≥ 7 was a better indicator of in-hospital costs compared to the diagnosis of diabetes. Patients with HbA1c ≥ 7 also had prolonged hospital stays and higher mortality rates, in addition to high in-hospital costs.
Conclusions:
Routine testing of HbA1c levels might be cost-effective and should be performed at primary healthcare facilities.
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