DIABETIC-KETOACIDOSIS CHARGES RELATIVE TO MEDICAL CHARGES OF ADULT PATIENTS WITH TYPE-I DIABETES

OBJECTIVE - To determine the medical charges for treating diabetic ket oacidosis (DKA) episodes relative to direct medical care charges of ad ult patients with type I diabetes. RESEARCH DESIGN AND METHODS - Using data from an electronic medical record system, we identified adult pa tients with type I diabetes who had received inpatient or outpatient c are on at least two occasions between 1 January 1993 and 30 June 1994. Resources and charges for hospitalizations, emergency room visits, ou tpatient visits, and pharmaceuticals were recorded during this period. One additional year of information was collected to assess the resour ces and charges associated with multiple DKA episodes. RESULTS - A tot al of 200 patients were identified, of whom 72 (36.0%) experienced a t otal of 161 DKA episodes. The direct medical care charges associated w ith DKA episodes repre sented 28.1% of the direct medical care charges for the cohort of patients with type I diabetes. The average charge p er DKA episode was $6,444. The estimated annual medical care charge fo r each patient was $7,855 ($13,096 per patient experiencing a DKA epis ode Versus $4,907 per patient not experiencing an episode). Multiple D KA episodes were experienced by 24 (12.0%) of the study patients and a ccounted for 55.6% of the direct medical care charges for these patien ts. CONCLUSIONS - DKA episodes represented more than $1 of every $4 sp ent on direct medical care for adult patients with type I diabetes and $1 of every $2 in those patients experiencing multiple episodes. Inte rventions that are capable of even a modest reduction in the number of DKA episodes could produce substantial cost savings in a health care system and could be particularly cost-effective in adult patients with recurrent DKA.