Hospitalization among diabetic children and adolescents and the general population in Germany

OBJECTIVE - To compare hospitalization in a multicenter-based cohort of dia betic children and adolescents (aged 1-19 years) in Germany with that of th e general population. RESEARCH DESIGN AND METHODS - Based on standardized documentation, hospital stays after manifestation were ascertained in diabetic subjects 1-19 years of age in 1997. Hospitalization data in the general German population were derived from official statistics. Incidence rates and numbers of hospital days were estimated. Ratios of hospitalization incidences and numbers of ho spital days between the diabetic and the general population were calculated . Costs Tor hospital care in the German diabetic population in 1997 were de termined. RESULTS - A total of 5,874 patients came from 61 pediatric centers (52% mal e, age [mean +/- SD] 12.2 +/- 4.3 years, diabetes duration 4.6 +/- 4.4 year s). Hospitalization incidence rates and hospital days per person-year (95% CI) were 0.27 (0.25-0.29) and 1.80 (1.75-1.84) in the diabetic population a nd 0.0948 (0.0946-0.0949) and 0.6416 (0.6412-0.6420) in the general populat ion. The standardized ratio of hospital incidences was 3.1 (2.9-3.2), and t he ratio of numbers of hospital days was 2.8 (2.7-2.9). Costs for hospital care after manifestation were estimated to he $506 (U.S. dollars) per perso n-year and $12.4 million in the whole German diabetic population aged 1-19 years in 1997; including hospital stays at diabetes onset, total annual tes ts were $24 million ($970 per person-year). fCONCLUSIONS - Diabetic children and adolescents in Germany had an arrroxim ately three times higher hospitalization risk and three times more hospital days than the age-matched general population. Including hospitalization at diabetes onset, the annual costs of hospital care for the German diabetic population aged 1-19 years amounted to similar to1% of all costs for hospit al care in this age-group. Thus, costs were largely overproportional (diabe tes prevalence 0.1%).