The cost analysis of the diagnostic laboratory tests of diabetes mellitus in an university hospital

One of the important issues of the health economics is to make management plan of the most frequent, debilitiating and fatal diseases; because of the budget practices in diagnosis of the diseases. Considering the prevalance and the incidence rates of diabetes, the cost of the diagnostic strategy used in diagnosis became very important. The aim of this study is to analyze the cost of the diagnostic laboratory tests of DM in an university hospital. This cross-sectional study has a metodological component. The participants of the study is consist of people who was older than 18 years old, had not been diagnosed as DM and admitted to the GUSUAH internal medicine outpatient clinics with any reason and gone under a laboratory test determining blood glucose level between 1 December 2012 and 28 February 2013. The coverage level of the study was 67,09 %. The categorical variables were represented as number and percentage, the contunious variables were shown as mean±standard deviation and meadian ( minimum, maximum). The Chi-square and Mann-Whitney U tests were used in comparison of the data according to the status of the DM diagnosis. The ROC curve was used to determine the cut-off points of HbA1c. p<0,05 was accepted as statistical significance level. The Decision Tree analysis was used to calculate the weighted costs. 520 people were reached in this study. The prevalance of DM was 16,3 % and the pre-DM was 15,0 %. During the study period the total cost of the used test was 4162,2 TL, the average per person cost was 7,98 TL and the average per diagnosis cost was 48,96 TL. According to the weighted costs, the strategy in which the FPG and HbA1c was ordered together was the most cost-effective strategy in diagnosis of DM and the strategy in which only FPG was ordered was the most cost-effective strategy in diagnosis of ?not DM?. The value 6,25% was found to be more appropriate as cut-off point of HbA1c. The cost of diagnostic strategies offered in national and international guidelines are cheaper than strategies used in our hospital. Also, most of the strategies used were found to be more expensive. For this reason, diagnostic guidelines must be prepared for the responsible physicians in clinics and must be kept at where physicians can reach anytime or at least the most cost-effective strategies found in this study should be offered. Being carried out in one hospital restricts results to be universalized. Multi-centre studies analyzing diagnostic strategies of DM and the costs will lead costs and sources to be used effectively. Key words: Diabetes mellitus, diagnostic tests, cost.