Prevalence and Hospitalization Costs of Long-Term Complications in Hospitalized Patients with Diabetes Mellitus in China: A Nationwide Hospital-Based Study

Background: There is absence of national data to estimate the prevalence and the hospitalization costs of long-term diabetic complications among hospitalized patients with diabetes in China. Methods: Using the national Hospital Quality Monitoring System (HQMS) database, we identified inpatients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) via ICD-10 code and calculated the proportion of inpatients with microvascular complications and macrovascular complications 2013-2017. We then investigated the changes of hospitalization costs before, during and after the year when the complications occurred. Findings: A total of 92,413 inpatients with T1DM and 6,094,038 inpatients with T2DM were identified 2013-2017. The proportions of inpatients with microvascular complications in inpatients with T1DM and T2DM increased from 29·9% and 19·0% in 2013 to 31·6% and 21·0% in 2017, respectively. The proportions of inpatients with macrovascular complications in inpatients with T1DM and T2DM increased from 7·3% and 14·5% in 2013 to 13·2% and 18·4% in 2017, respectively. Compared with the average annual hospitalization costs before the occurrence of kidney transplantation, dialysis, acute myocardial infarction, stroke, diabetic foot, nephropathy, retinopathy and neuropathy among inpatients with T2DM, the hospitalization costs of the year when the long-term complications occurred increased by 249·0%, 120·9%, 172·0%, 61·3%, 61·5%, 34·0%, 22·9% and 24·6%, respectively. The growth of hospitalization costs of inpatients with T1DM after the occurrence of long-term complications were 339·8%, 197·2%, 347·5%, 106·3%, 22·5%, 33·9%, 26·8% and 109·5%, respectively. Interpretation: The proportions of long-term complications of inpatients with diabetes in China increased 2013-2017. The hospitalization costs of inpatients with diabetes in China increased significantly after the occurrence of long-term complications. Funding: China-World Health Organization Biennial Collaborative Projects Declaration of Interest: None to declare. Ethical Approval: This study was approved by the Ethics Committees of the First Affiliated Hospital of Sun Yat-sen University.