OBJECTIVES: Recent studies have reported a declining trend in the rate of hypoglycemia-related hospitalizations in the United States (US), however little is known about corresponding trends in healthcare costs. This study aims to explore trend in direct medical costs associated with hypoglycemia-related hospitalizations using a nationally representative data from the US.

METHODS: Data for years 2001 to 2011 were obtained from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS), a cross-sectional survey based on stratified random sampling of discharges in community hospitals in the US. Hospital discharges with a diagnosis of hypoglycemia for patients aged ≥18 years were queried. Total costs were estimated by applying Medicare average cost-to-charge ratios to reported charges. Costs were adjusted for inflation using medical care component of the US Consumer Price Index. NIS-assigned discharge weights were used to derive nationally-representative estimates. Multivariable generalized linear models were performed to assess total annual and average per patient costs by calendar year for the overall sample and by age group. All models were risk-adjusted for age, sex, and Elixhauser comorbidities.

RESULTS: An estimated total of 1.5 million patients were admitted for hypoglycemia during the study period; hypoglycemia hospitalizations increased from 115,367 in 2001 to 161,267 in 2011. The total inflation-adjusted annual costs for hypoglycemia-related hospitalizations in 2001 were $1.2 billion, with an average cost of $10,343 (95% CI: $10,187-$10,500) per hospitalization. The total annual costs increased to $1.6 billion in 2011, but with little change in the average cost per hospitalization ($10,139 [95% CI: $10,011-$10,268]). In the age-stratified analysis, the estimated costs were highest in the age group 45-64 years ($12,131 [95% CI: $12,063-$12,198]) and lowest in the age group ≥85 years ($8,401 [95% CI: $8,260-$8,541]).

CONCLUSIONS: Hypoglycemia-related annual hospitalization costs in the US are substantial and have increased in recent years, driven primarily by growth in hypoglycemia discharges.