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Exp Clin Endocrinol Diabetes 2012; 120(01): 35-44
DOI: 10.1055/s-0031-1291178
Article
© Georg Thieme Verlag KG Stuttgart · New York

Socioeconomic Correlates of Inpatient Spending for Patients with Type 2 Diabetes Mellitus in China: Evidence from Hangzhou

H. Li
1   Sir Run Run Shaw Hospital Affiliated with School of Medicine, Zhejiang University, Endocrinology, Hangzhou, China
,
B. K. Chen
2   Stanford University Shorenstein Asia-Pacific Research Center, Stanford, United States
,
N. Shah
3   College of Medicine, Mayo Clinic, Division of Health Care Policy and Research, MN, United States
,
Z. Wang
1   Sir Run Run Shaw Hospital Affiliated with School of Medicine, Zhejiang University, Endocrinology, Hangzhou, China
,
K. N. Eggleston
4   Stanford University, Shorenstein Asia-Pacific Research Center, Stanford, United States
› Author Affiliations
Further Information

Publication History

received 24 March 2011
first decision 15 September 2011

accepted 15 September 2011

Publication Date:
11 January 2012 (online)

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Abstract

Aims:

We evaluated the factors associated with inpatient costs including total costs, pharmaceutical costs and laboratory costs for diabetes-related admissions.

Patients and Methods:

Using data for 960 adult patients admitted between May 2005 and April 2008 with a primary or secondary diagnosis of type 2 diabetes mellitus (DM) at Sir Run Run Shaw Hospital affiliated with Zhejiang University Medical School (SRRSH) in Hangzhou, China, we evaluate the association between patient characteristics and inpatient costs with multivariable regression analyses.

Results:

Total inpatient costs were positively associated with age, higher UKPDS stroke risk score, and presence of any complication. A regression that included patient socioeconomic and clinical characteristics explained 21.5% of the variation in total inpatient costs; regression estimates indicate that patients with coronary artery disease, retinopathy, nephropathy, neuropathy, and diabetic foot had inpatient costs that were respectively 93.7%, 14.0%, 17.5%, 11.5% and 89.0% higher than otherwise similar patients without those complications. Pharmaceutical costs did not differ by insurance coverage. Insured patients spent 7–16% more on laboratory tests than otherwise similar patients did.

Conclusions:

Clinical factors, especially presence of diabetes-related complications, appear to be the primary determinants of variation in inpatient costs for patients with type 2 DM in China. To mitigate the health costs increases associated with China’s DM epidemic, policymakers should focus on cost-effective ways to manage patients in outpatient settings to prevent the complications associated with diabetes.

Key words

Asian diabetes - developing countries - economics - health care delivery - type 2 diabetes
 

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