ECONOMIC BURDEN OF INTENSIVE CARE UNIT MANAGEMENT FOR DIABETIC KETOACIDOSIS: A PILOT PROSPECTIVE COST ANALYSIS
Author(s)
Aljawharah F. Alkoraishi, Dr1, Raed alenezi, Dr2, Metib alotaibi, Dr3, Fatimah Alyami, Dr4.
1King Saud University Medical City, Riyadh, Saudi Arabia, 2Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia, 3ksumc, riyadh, Saudi Arabia, 4Center of Health Technology Assessment, Riyadh, Saudi Arabia.
1King Saud University Medical City, Riyadh, Saudi Arabia, 2Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia, 3ksumc, riyadh, Saudi Arabia, 4Center of Health Technology Assessment, Riyadh, Saudi Arabia.
OBJECTIVES: Diabetic ketoacidosis (DKA) is an acute complication of diabetes that frequently requires intensive care unit (ICU) admission, concentrating costly hospital resources; in Saudi Arabia, recurrent DKA admissions are a recognized economic burden. Yet ICU cost analysis remains underdeveloped in the Kingdom, where direct ICU cost has been estimated at roughly SAR 23,000 (approximately USD 6,133) per patient-day, and patient-level DKA costing is essentially absent. This pilot prospective study quantified the direct medical cost of ICU-managed DKA at a tertiary Saudi center and identified the principal cost drivers.
METHODS: A prospective observational micro-costing analysis was conducted on consecutive ICU patients with DKA. The patient journey was mapped across four phases—emergency care, ICU treatment, ward stabilization, and discharge—and direct costs were captured at the patient level from hospital billing and electronic health records, comprising emergency, ICU, and ward bed-days; physician/staffing; laboratory tests; medications; and procedures (USD). Descriptive statistics summarized cost; component shares and the correlation between ICU length of stay (LOS) and total cost were assessed.
RESULTS: Nineteen patients were enrolled (mean age 39.1 years; mean ICU stay 3.1 days). Total direct cost was USD 142,101, with a mean of USD 7,479 per patient (median USD 7,164). Cost varied largely with clinical severity, as more severe presentations required longer ICU stays and higher per-patient cost than milder cases. ICU bed-day cost was the single largest component, whereas medications, laboratory tests, and procedures together contributed only a minor fraction. Total cost was strongly correlated with ICU LOS, confirming bed-day occupancy as the principal economic driver.
CONCLUSIONS: In this pilot Saudi cohort, the economic burden of ICU-managed DKA was overwhelmingly driven by ICU bed-day occupancy rather than drugs, labs, or procedures. Interventions that safely shorten ICU LOS—earlier step-down and protocolized care—offer the greatest cost-containment potential. Larger multicenter studies are warranted to confirm these findings.
METHODS: A prospective observational micro-costing analysis was conducted on consecutive ICU patients with DKA. The patient journey was mapped across four phases—emergency care, ICU treatment, ward stabilization, and discharge—and direct costs were captured at the patient level from hospital billing and electronic health records, comprising emergency, ICU, and ward bed-days; physician/staffing; laboratory tests; medications; and procedures (USD). Descriptive statistics summarized cost; component shares and the correlation between ICU length of stay (LOS) and total cost were assessed.
RESULTS: Nineteen patients were enrolled (mean age 39.1 years; mean ICU stay 3.1 days). Total direct cost was USD 142,101, with a mean of USD 7,479 per patient (median USD 7,164). Cost varied largely with clinical severity, as more severe presentations required longer ICU stays and higher per-patient cost than milder cases. ICU bed-day cost was the single largest component, whereas medications, laboratory tests, and procedures together contributed only a minor fraction. Total cost was strongly correlated with ICU LOS, confirming bed-day occupancy as the principal economic driver.
CONCLUSIONS: In this pilot Saudi cohort, the economic burden of ICU-managed DKA was overwhelmingly driven by ICU bed-day occupancy rather than drugs, labs, or procedures. Interventions that safely shorten ICU LOS—earlier step-down and protocolized care—offer the greatest cost-containment potential. Larger multicenter studies are warranted to confirm these findings.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE627
Topic
Economic Evaluation, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas