OBJECTIVES

Severe hypoglycemic events (SHEs) make a substantial contribution to the overall burden of diabetes but data on the costs and clinical impact of SHEs in Iran are lacking. The aim of the analysis was to determine the mean total direct hospitalization cost of patients with diabetes admitted to hospital with a SHE in Iran.

METHODS

A multicenter analysis was conducted across 27 health centers in Iran over the period 2017–2018. Patients with diabetes admitted with severe hypoglycemia were identified using ICD-10 codes, billed costs were calculated using national tariffs. National Tariffs, which are used in public hospitals and are determined by the Government do not reflect actual costs. It was assumed that actual inpatient treatment costs in public hospitals were approximately one-third higher than billed costs, reflecting government subsidies for patients using public services.

RESULTS

370 patients with SHEs were included in the analysis. The mean age was 66.3 years and mean length of stay (LoS) was 3.8 days. Approximately 43% of patients had a LoS of ≥4 days and 15% had a LoS ≥7 days.

The mean hospitalization cost of a SHE was IRR 19,739,083; however, the mean actual cost from a health system perspective was estimated at approximately 35% higher at IRR 26,647,762 per SHE. Event costs were 57% higher in patients with diabetes-related complications compared with patients without complications or comorbid conditions (IRR 15,258,656).

CONCLUSIONS

In Iran, the clinical and economic burden associated with SHEs, particularly in elderly patients and those with existing complications or comorbidities is substantial. Estimates based on national tariffs may underestimate the true cost of SHEs. Further studies are needed to more fully characterize the burden of SHEs in Iran at a national level.