OBJECTIVES: The study objective was to analyse hospitalization costs of type-2 diabetes mellitus (DM2) patients incl. costs of comorbidities, and to compare the DRG reimbursement rates with the theoretical reimbursement calculated according to the Decree of the Ministry of Health No. 428/2013 Coll. on the point values, the amount of reimbursement for paid services, and regulatory constrains for the year, in a selected district hospital in the Ústí Region in 2015.

METHODS: The analysed sample consisted of all 159 patients treated in the hospital with DM2 (ICD-10 classification: E11.0-E11.9) as the primary or secondary diagnosis in 2015. Simultaneously, the following DM2 comorbidities were recorded: ischaemic heart diseases (I20-I25), cerebrovascular diseases (I60-I69), diseases of arteries, arterioles and capillaries (I70-I79), and/or renal failure (N17-N19). Costs were analysed according to the particular diagnoses. Consequently, the interdependence of the reimbursement according to the DRG rates and that according to the point values was studied.

RESULTS: Obviously, comorbidities cause an increase in the treatment costs. While the average DRG reimbursement was CZK19,482 (~EUR756) in the hospitalizations where a diagnosis from E11.0-E11.9 was the only one assigned, the combination with the studied comorbidities led to higher costs, namely CZK23,627 (EUR916) for I20-I25, CZK25,246 (EUR979) for I60-I69, CZK40,886 (EUR1,585) for I70-I79, and CZK30,509 (EUR1,183) for N17-N19. The differences between the two compared reimbursement systems show that the reimbursement according to the DRG only accounts for 60% of the reimbursement based on point values.

CONCLUSIONS: The costs of DM2 treatment significantly grow with the presence of comorbidities, especially with the diseases of arteries, arterioles and capillaries. The reimbursement according to DRG is up to 40% lower that the classic reimbursement according to the point value calculated according to the Decree No. 428/2013 Coll., which constitutes a stark contrast and an economic challenge for the hospital management.