OBJECTIVES : Based on diabetes patients with and without hypoglycaemia, we assessed the cost of hypoglycaemic events on China’s hospital system.

METHODS Data regarding diabetes episodes (including 1417 patients with hypoglycaemia and 5693 diabetes patients without hypoglycaemia) were collected on each patient from the hospital’s health information system. The additional hospital costs caused by hypoglycaemia were assessed by the cost difference between diabetes patients with and without hypoglycaemia. China-wide hospital costs of hypoglycaemia were estimated based on average additional hospital costs caused by hypoglycaemia, the prevalence of diabetes and hypoglycaemia events and the rates of hospitalization. Multiple sensitivity analyses were conducted to assess the impact of variations in the key input parameters on the primary estimates.

RESULTS : The total hospital costs for patients with hypoglycaemia (US$3020.61) were significantly higher than that of patients without hypoglycaemia (US$1642.91). The average additional cost caused by hypoglycaemia was US$1377.70, with higher average costs of US$1875.89 for severe hypoglycaemia and lower average costs of US$1244.76 for non-severe hypoglycaemia. The additional hospital cost caused by severe and non-severe hypoglycaemia was higher for the 60-75 year old group, married and patients accessing free medical services. The total annual additional hospital costs arising from hypoglycaemia events in China were estimated to be US$4.85 billion. Sensitivity analyses suggested that the costs of hypoglycaemia events ranged up to US$5.10 million at the upper 95% confidence interval and US$4.61 billion with lower 95% confidence interval.

CONCLUSIONS : Hypoglycaemic events imposed a substantial cost on China’s hospital system, with certain subgroups of patients, such as older patients and those with free health insurance, using medical resources more intensively to treat hypoglycaemia events. We recommend more effective planning of prevention and treatment regimens for hypoglycaemia patients; further reform to China’s health insurance schemes; and better hospital cost control for those accessing free hospital services.