OBJECTIVES:

Diabetic ketoacidosis (DKA) is a commonly encountered metabolic emergency. In 2014 a national survey was conducted looking at the management of DKA in adult patients across the UK. The survey reported the clinical management of individual patients as well as institutional factors that teams felt were important in helping to deliver that care. However, costs of treating DKA were not reported. We estimate these costs here.

METHODS:

We used a combination of bottom-up and top-down costing to estimate the total costs associated with treating DKA in a mixed population sample. The data were derived from the source data from the national UK survey of 283 individual patients collected via questionnaires sent to hospitals across the country. Because the initial survey collection tool was not designed with a health economic model in mind, several assumptions were made when analysing the data. We used multiple imputation methods to account for missing data.

RESULTS:

The mean and median time in hospital was 5.6 and 2.7 days, respectively. Based on the individual patient data and using the Joint British Diabetes Societies Inpatient Care Group guidelines, the cost analysis suggests that for this cohort, the average cost for an episode of DKA was £2064 per patient (95% CI: £1800, 2563). An episode of hypoglycaemia following DKA was the only statistically significant predictor of cost (-£935, p=0.03).

CONCLUSIONS:

Despite relatively short stays in hospital, costs for managing episodes of DKA in adults were relatively high. However, we were unable to account for prolonged hospital stays due to co-morbidities or indirect costs such as lost productivity. Therefore, the actual costs to the healthcare system and to larger society are likely to be even higher than these first estimates.