Incidence and costs of severe hypoglycaemia requiring attendance by the emergency medical services in South Central England

Farmer, Andrew; Brockbank, Katrina; Keech, M.; England, Ed; Deakin, Charles D.

doi:10.1111/j.1464-5491.2012.03657.x

Cited by 56 publications

(64 citation statements)

References 5 publications

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“…A study in a smaller population in the UK recently described similar results on the incidence of SHEs requiring attendance by emergency medical services 28. However, Farmer et al .…”

Section: Discussionmentioning

confidence: 69%

Incidence and care‐related costs of severe hypoglycaemia requiring emergency treatment in Andalusia (Spain): the PAUEPAD project

et al. 2015

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AimsHypoglycaemia is a serious medical emergency. The need for emergency medical service care and the costs of hypoglycaemic emergencies are not completely known.MethodsThis was a retrospective observational study using Public Company for Health Emergencies (EPES) data for hypoglycaemia in 2012. The EPES provides emergency medical services to the entire population of Andalusia, Spain (8.5 million people). Data on event type, onsite treatments, emergency room visits or hospitalization were collected. Medical costs were estimated using the public rates for healthcare services.ResultsFrom a total of 1 137 738 emergency calls that requested medical assistance, 8683 had a primary diagnosis of hypoglycaemia (10.34 per 10 000 person‐years). The incidence of severe hypoglycaemic episodes requiring emergency treatment in the estimated population with diabetes was 810 episodes per 10 000 person‐years. A total of 7479 episodes (86%) required an emergency team to visit the patient's residence. The majority of cases (64%) were addressed in the residence, although 1784 (21%) cases were transferred to hospital. A total of 5564 events (65%) involved patients aged > 65 years. Overall mortality was 0.32% (28 cases). The total annual cost of attending a hypoglycaemic episode was €6 093 507, leading to an estimated mean direct cost per episode of €702 ± 565. Episodes that required hospital treatment accounted for 49% of the total costs.ConclusionsHypoglycaemia is a common medical emergency that is associated with high emergency medical service utilization, resulting in a significant economic impact on the health system.

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“…A study in a smaller population in the UK recently described similar results on the incidence of SHEs requiring attendance by emergency medical services 28. However, Farmer et al .…”

Section: Discussionmentioning

confidence: 69%

Incidence and care‐related costs of severe hypoglycaemia requiring emergency treatment in Andalusia (Spain): the PAUEPAD project

et al. 2015

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“…The weakness of this model is that SH patients managed successfully by Ambulance Crew do not then receive any additional education triggered by the SH event, and the patient's normal primary or secondary care diabetes team often remain unaware of these episodes. In one large UK population more than half of ambulance attended SH patients either declined further treatment or were only advised to seek further advice at their discretion [18]. This is important, as many patients with SH make multiple calls about SH to emergency services, describe multiple previous SH episodes, and have had little advice or education on SH avoidance.…”

mentioning

confidence: 99%

“…Effective management of SH is one of the key performance indicators for UK Ambulance Trusts (16) and they operate effective 'see and treat' policies for SH, where Ambulance Crew manage the episode at the scene, with few patients carried onwards to a local emergency department or admitted [17,18]. The weakness of this model is that SH patients managed successfully by Ambulance Crew do not then receive any additional education triggered by the SH event, and the patient's normal primary or secondary care diabetes team often remain unaware of these episodes.…”

mentioning

confidence: 99%

A new integrated care pathway for ambulance attended severe hypoglycaemia in the East of England: The Eastern Academic Health Science Network (EAHSN) model

Sampson

Bailey

Clark

et al. 2017

Diabetes Research and Clinical Practice

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A new integrated care pathway for Ambulance attended severe hypoglycaemia in the East of England: the Eastern Academic Health Science Network (EAHSN) model, Diabetes Research and Clinical Practice (2017), doi: http://dx.doi.org/10.1016/ j.diabres. 2017.08.017 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Methods SH patients attended by Ambulance crew receive written information on SH avoidance, and are contacted for further education through a new regional SH prevention team. All patients are contacted unless they actively decline.Results Median age (IQR) was 67 (50 -80) years, 23.6% of calls were for patients over 80 years old, and patients more than 90 years old were more common than 20 -25 year olds in this population. Most calls were for patients (84.9%) who were insulin treated, even those over 80 years (75%). One -third of patients attended after a call were unconscious on attendance. 5.6% of patients in this call population had 3 or more ambulance call outs, and they generated 17.6% of all calls. In total, 728 episodes (36.4%) were repeat calls. Insulin related events were clinically more severe than oral hypoglycaemic related events. Patients conveyed to hospitals (13.8%) were significantly older, with poorer recovery in biochemical hypoglycaemia after ambulance crew attendance. Only 19 (1 %) opted out of further contact. Patients were contacted by the SH prevention team after a median 3 (0 -6) days. The most common patient self -reported cause for their SH episode was related to percieved errors in insulin management (31.4%). ConclusionsThis new clinical service is simple, acceptable to patients, and a translatable model for prevention of recurrent SH in this largely elderly insulin treated SH population.

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“…Thirty-five percent of all cases of very severe hypoglycemia are hospitalized, 65% treated by ambulance only. 44,45 To calculate the average cost for a severe hypoglycemic event, the aspect was incorporated into the analysis: €2541 × 0.35) + (€520 × 0.65) = €1227.…”

Section: Resultsmentioning

confidence: 99%

“…39 These results are confirmed by other studies, some of them of German origin. [40][41][42][43] The fact that 35% of patients with severe hypoglycemia require hospitalization and 65% can be treated by (para)medical personnel (i.e., required ambulance use only) 44,45 was also included into the analysis.…”

Section: Costs Of Severe Hypoglycemia and Myocardial Infarction In Gementioning

confidence: 99%

Higher Accuracy of Self-Monitoring of Blood Glucose in Insulin-Treated Patients in Germany: Clinical and Economical Aspects

Schnell

Erbach²,

Wintergerst

2013

J Diabetes Sci Technol

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Incidence and costs of severe hypoglycaemia requiring attendance by the emergency medical services in South Central England

Cited by 56 publications

References 5 publications

Incidence and care‐related costs of severe hypoglycaemia requiring emergency treatment in Andalusia (Spain): the PAUEPAD project

Incidence and care‐related costs of severe hypoglycaemia requiring emergency treatment in Andalusia (Spain): the PAUEPAD project

A new integrated care pathway for ambulance attended severe hypoglycaemia in the East of England: The Eastern Academic Health Science Network (EAHSN) model

Higher Accuracy of Self-Monitoring of Blood Glucose in Insulin-Treated Patients in Germany: Clinical and Economical Aspects

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