Endocrine Abstracts

Universal screening for gestational diabetes mellitus (GDM) has recently been recommended as part of the national model of care. The resultant expected increase in incidence of the condition will have implications for healthcare expenditure. We wished to evaluate the costs associated with both one-step and two-step methods of GDM screening. We performed a time-driven activity-based costing (TDABC) method of cost analysis in two centres using differing screening methods and analysed the associated cost of each step in the GDM screening process. The screening process for three participants in both sites was followed to calculate the average cost of a one-step and two-step GDM screen. We estimated annual expenditure on GDM screening using the birth rates from the hospital annual reports. Estimated numbers (28%) proceeding to the second step of two-step screening were calculated using data from our previous work. The estimated costs of a 75g glucose tolerance test, 50g glucose challenge test and 100g glucose tolerance test were C= 26.64, C= 19.21, and C= 34.09 per test, respectively. Estimated annual costs of screening were C= 186,480 and C= 201,286 for the one and two-step methods, with cost per case screened C= 26.64 and C= 28.76. Higher numbers of patients being screened for GDM will equate to a higher expenditure on GDM, both in terms of screening for and treatment of the condition, though longer term benefits may be seen and should be studied. Due provision to the higher workload with increased hospital staffing is recommended for the increased volume of testing and treatment.