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Phillips VL, Byrd AL, Adeel S, et al. A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens. Pharmacoecon Open. 2017;1(2):109-115doi: 10.1007/s41669-017-0020-9.
Phillips, V. L., Byrd, A. L., Adeel, S., Peng, L., Smiley, D. D., & Umpierrez, G. E. (2017). A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens. PharmacoEconomics - open, 1(2), 109-115. https://doi.org/10.1007/s41669-017-0020-9
Phillips, Victoria L, et al. "A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens." PharmacoEconomics - open vol. 1,2 (2017): 109-115. doi: https://doi.org/10.1007/s41669-017-0020-9
Phillips VL, Byrd AL, Adeel S, Peng L, Smiley DD, Umpierrez GE. A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens. Pharmacoecon Open. 2017;1(2):109-115. doi: 10.1007/s41669-017-0020-9. Epub 2017 Apr 21. PMID: 28660256; PMCID: PMC5468101.
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Pharmacoecon Open. 2017;1(2):109-115. doi: 10.1007/s41669-017-0020-9. Epub 2017 Apr 21.

A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens.

PharmacoEconomics - open

Victoria L Phillips, Anwar L Byrd, Saira Adeel, Limin Peng, Dawn D Smiley, Guillermo E Umpierrez

Affiliations

  1. Department of Health Policy and Management, Rollins School of Public Health of Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA.
  2. Department of Medicine, Division of Endocrinology, Emory University School of Medicine, Atlanta, GA USA.
  3. Department of Biostatistics, Rollins School of Public Health, Atlanta, GA USA.

PMID: 28660256 PMCID: PMC5468101 DOI: 10.1007/s41669-017-0020-9

Abstract

BACKGROUND: The identification of cost-effective glycaemic management strategies is critical to hospitals. Treatment with a basal-bolus insulin (BBI) regimen has been shown to result in better glycaemic control and fewer complications than sliding scale regular insulin (SSI) in general surgery patients with type 2 diabetes mellitus (T2DM), but the effect on costs is unknown.

OBJECTIVE: We conducted a post hoc analysis of the RABBIT Surgery trial to examine whether total inpatient costs per day for general surgery patients with T2DM treated with BBI (

METHODS: Data were collected from patient clinical and hospital billing records. Charges were adjusted to reflect hospital costs. General linearized models were used to estimate the risk-adjusted effects of BBI versus SSI treatment on average total inpatient costs per day.

RESULTS: Risk-adjusted average total inpatient costs per day were $US5404. Treatment with BBI compared with SSI reduced average total inpatient costs per day by $US751 (14%; 95% confidence interval [CI] 20-4). Being treated in a university medical centre, being African American or having a bowel procedure or higher-volume pharmacy use significantly reduced costs per day.

CONCLUSIONS: In general surgery patients with T2DM, a BBI regimen significantly reduced average total hospital costs per day compared with an SSI regimen. BBI has been shown to improve outcomes in a randomized controlled trial. Those results, combined with our findings regarding savings, suggest that hospitals should consider adopting BBI regimens in patients with T2DM undergoing surgery.

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