Burden of Hospitalizations Primarily Due to Uncontrolled Diabetes

Abstract

This study describes the burden of potentially preventable hospitalizations primarily due to uncontrolled diabetes. Uncontrolled diabetes, if not managed properly, often leads to biochemical imbalances that can cause acute life-threatening events and hospitalizations. Since diabetes management relies heavily on ambulatory care, hospitalizations with uncontrolled diabetes largely reflect the quality of the primary health care provided outside the hospital setting. Therefore, the Agency for Healthcare Research and Quality (AHRQ) selected uncontrolled diabetes as a prevention quality indicator (PQI) where timely and appropriate ambulatory care would have prevented a hospitalization (1). To improve primary health care, it is essential to track an outcome of current status of prevention quality indicators. However, the extent of potentially preventable hospitalizations associated with uncontrolled diabetes and its economic burden in the U.S. remains under-investigated. A primary diagnosis indicative of uncontrolled diabetes was analyzed using two nationally representative samples of inpatients records. First, to estimate the number of potentially preventable hospitalizations, the National Hospital Discharge Survey (NHDS) was analyzed. The NHDS-2004, the latest annual survey available (2), acquired a probabilistic sample of 370,785 inpatient records from a national sample of ∼500 hospitals. Overall, the hospital response rate was 92% in 2004 (3). Details concerning sampling procedures are published elsewhere (4). Briefly, the NHDS, conducted annually since 1965, is …