Hospitalization for general medical conditions among diabetic patients in Israel.

BACKGROUND: Diabetes mellitus is a serious, costly and growing public health problem. Very few studies have been published on the economic impact of diabetes in Israel. OBJECTIVE: To estimate health fund expenditures and rates of hospitalization for general conditions among the diabetic population in Israel. METHODS: The total number of hospitalizations in Israel in 1998 of beneficiaries of the General Sick Fund (Kupat Holim Clalit) was obtained from its bureau of statistics. The diabetic and general populations were compared for age and gender distribution, days of hospitalization and cost of hospitalization. All hospitals in Israel were included. RESULTS: There were 618,317 general admissions for a total of 3,005,288 hospitalization days. The diabetic population accounted for 11.5% of all admissions and 13.7% of all hospitalization days. Analysis by age revealed that diabetic patients over age 45 represented 18.3% of all admissions and 17.5% of all hospitalization days. The average stay in hospital was 4.8 days per patient for the general population and 5.3 days for diabetic patients. The overall hospital expenditure of the GSF for general medical conditions among diabetic patients in 1998 was estimated at US $173,455,790, of which 57% accounted for the daily hospitalization cost. Of the total hospital expenditures for that year, 13.3% was allocated to patients with diabetes of whom 96.4% were over 45 years old. No significant difference was found between males and females. CONCLUSION: Hospital expenditures for diabetic people increase with patient age and represent one-fifth of the total health insurance expenditure for the middle-aged and elderly population.

Ovarian tumors in pregnancy.

Thirty-eight women were operated for an ovarian tumor diagnosed during pregnancy, with an incidence of 1/2328 deliveries. The diameter of all tumors was above 5 cm. Of the 31 women operated before delivery, seven were untreated and 24 received supportive progestational therapy. The rate of abortions was 85.7% in the untreated group and 10% in the hydroxy-progesterone-caproate group (HPC) (P less than 0.02). When the women received a total dose of HPC of more than 300 mg, 9 of 10 pregnancies reached term with a live child. Two ovarian malignancies were found, 5.3% of all cases. In 42.9% of the women there were fertility problems later in life. Ovarian tumors during pregnancy should be removed as soon as possible, irrespective of the age of the pregnancy. If fully progesterone therapy is given, the danger of abortions is reduced to a minimum. Prophylactic antibiotic treatment should also be administered.