ABSTRACT
OBJETIVO: Analizar los costos de atención ambulatoria de personas con diabetes hospitalizadas por causas relacionadas con esta enfermedad -anteriores o posteriores a la hospitalización- y compararlos con los de personas diabéticas que no fueron hospitalizadas durante el mismo período. MÉTODOS: Determinamos los gastos de atención hospitalaria y ambulatoria de personas con diabetes afiliadas a una empresa argentina de medicina prepaga que habían sido hospitalizadas durante el período de estudio y comparamos estos últimos con los de afiliados diabéticos que no habían sido hospitalizados durante dicho período. RESULTADOS: Identificamos 2 760 personas con diabetes (2,4 por ciento del total de afiliados a la empresa de medicina prepaga); de ellas, 1 683 (59 por ciento) trataban la diabetes y los factores de riesgo cardiovascular asociados con medicación específica; la diabetes se asociaba con uno (41 por ciento) o dos (24 por ciento) factores de riesgo cardiovascular. De estas 1 683 personas, 102 (6 por ciento) fueron hospitalizadas por causas relacionadas con la diabetes durante el período estudiado; la frecuencia de hospitalización aumentó significativamente cuando la diabetes se asociaba con hipertensión arterial y dislipidemia. La enfermedad cardiovascular originó el 43,1 por ciento de las hospitalizaciones, con un costo per capita significativamente mayor que el registrado por otras causas (media ± error estándar de la media [1 673 ± 296,8] dólares estadounidenses [US$]; P < 0,05). Los costos totales anuales per capita de atención de las personas que fueron hospitalizadas resultaron mayores que los relativos a las que no fueron hospitalizadas (US$ [2 907,8 ± 262,5] frente a US$ [473,4 ± 9,8], respectivamente; P < 0,01). Los costos totales de atención ambulatoria posteriores a la hospitalización fueron un 12 por ciento mayores que los del período anterior a la hospitalización (US$ [903,6 ± 108,6] frente a US$ [797,6 ± 14,9]; diferencia...
OBJECTIVE: To analyze and compare the ambulatory care expenditures for persons with diabetes during prehospitalization and posthospitalization periods with those of diabetics who were not hospitalized for diabetes-related illnesses during the same period. METHODS: We determined the hospitalization and ambulatory care expenses incurred by an Argentine health insurer for the hospitalization of diabetic clients during the study period, and compared these expenses to the expenses of insured diabetics who were not hospitalized during that period. RESULTS: We identified 2 760 persons with diabetes (2.4 percent of the total number of persons covered by the insurance company). Of those, 1 683 (59 percent) were on medication for diabetes and its associated cardiovascular risk factors. Diabetes was associated with either one (41 percent) or two (24 percent) cardiovascular risk factors. Of those 1 683 persons, 102 (6 percent) were hospitalized for diabetes-related reasons during the study period. The frequency of hospitalization increased significantly in cases where diabetes was associated with arterial hypertension and dyslipidemia. Cardiovascular illness was the cause of 43.1 percent of the hospitalizations, with a significantly higher per capita cost than any of the other causes identified (mean ± standard error of the mean: US$ 1 673 ± US$ 296.8; P < 0.05). The total annual per capita cost for health care for the diabetics who had been hospitalized was greater than for those who had not (US$ 2 907.8 ± US$ 262.5 compared to US$ 473.4 ± US$ 9.8, respectively; P < 0.01). While the total posthospitalization ambulatory care expenditures were 12 percent higher than the prehospitalization costs (US$ 903.6 ± US$ 108.6 vs. US$ 797.6 ± US$ 14.9), the difference was not significant. CONCLUSION: Ambulatory care expenditures increase significantly in the prehospitalization and posthospitalization periods. The results suggest that intensive treatment of...