Cost of hospitalizations due to microvascular and macrovascular complications in type 1 and type 2 diabetic patients in Bulgaria

The objective of this study was to evaluate the cost of hospitalizations due to micro- and macrovascular complications in an observed cohort of 433 patients with diabetes. A six-month combined retrospective and prospective observational study was performed. The patients were separated into two groups depending on the type of diabetes and further into subgroups depending on the reason for hospitalization. The total costs for each subgroup were calculated and compared to the total costs of treatment for the observed period. In the type 2 diabetes group (n = 255), there were 128 people with microvascular complications and 215 ones with macrovascular complications, whereas in the type 1 diabetes group, there were only 70 people out of 178 with microvascular complications and 72 ones with macrovascular complications. The total cost of hospitalizations in the type 2 diabetes group was 34469.76 EUR with the following reported reasons for hospitalizations: poor control of diabetes (45%), microvascular complications (23%) and macrovascular complications (31%). In the type 1 diabetes group, the total hospitalizations cost was equal to 15319.33 EUR with the following split: 59% due to poor control of diabetes, 22% due to microvascular complications and 19% due to macrovascular complications. Thus, type 2 diabetes is more costly than type 1 when hospitalizations occur. Type 2 diabetes is associated with higher cost of macrovascular complications than of microvascular ones probably due to high hypertension prevalence. Costs are paid by the health insurance fund and the differences need to be systematically revealed.