Nearly one in five hospitalizations in 2008 involved patients with diabetes, according to a federal report. The cost of caring for those patients was $83 billion for 7.7 million stays, or nearly one in four dollars of hospital costs that year, a report from the Agency for Healthcare Research and Quality says.
The report also says that the average or mean cost of caring for that hospitalization was $10,937, nearly $2,200 more than the cost of a stay for a patient without a diagnosis of diabetes.
"Diabetes increases length of stay and therefore increases cost regardless of whether it is the primary reason for admission," the report states. "Patients with diabetes were, on average, much older than patients without diabetes, 65 vs 45)."
Patients with diabetes were more likely to be admitted to the hospital through the emergency department than patients without diabetes (72% for all stays involving patients in which diabetes was the principal reason for their hospitalization, 61% for all stays involving patients with diabetes and 42% for patients without diabetes.)
Diabetes as a reason for hospitalization varied greatly by region of the country, according to the report. Southern states had the highest rate, 2,829 hospitalizations per 100,000 population, followed by the Midwest, 2742, and the Northeast, 2,565. The West had the lowest rate of hospital stays for patients with diabetes, 1,866.
The report emphasized that only 1.4% of all hospital stays were for patients whose primary reason for admission was diabetes.
Other leading reasons why patients with diabetes required hospitalization included:
- Congestive heart failure
- Coronary atherosclerosis
- Pneumonia
- Septicemia
- Heart attack
- Chronic obstructive pulmonary disease
- Bronchiectasis
- Nonspecific chest pain
- Cardiac dysrhythmias
- Complication of a device, implant, or graft.
However, when a patient with diabetes was hospitalized, more often than not he or she had multiple co-morbidities, including hypertension, electrolyte disorders, chronic pulmonary disease, anemia, renal failure, obesity, congestive heart failure, hypothyroidism, depression and/or peripheral vascular disorder. Hospitalized patients with diabetes had on average 2.6 co-morbidities, as opposed to 1.3 co-morbidities for patients without diabetes.
The Centers for Medicare & Medicaid Services and other federal health officials are especially concerned about diabetes because more than 30% of hospital stays covered by Medicare involved patients with diabetes.
Said another way, "Medicare was the most common expected payer for hospital stays for patients with diabetes (60%) followed by private insurance (23%)," while for patients without diabetes, private insurance was the most common expected payer, (38%), followed by Medicare, (32%) and Medicaid (20%).
Also, people in lower income brackets were more likely to be hospitalized for diabetes than people in high income brackets, according to the report. For example, there were 3,232 diabetes stays per 100,000 people in the lowest income quartile, compared with 1,762 stays per 100,000 people in the highest income quartile.
The report is from H?CUP, the Healthcare Cost and Utilization Project, and is entitled Statistical Brief #93, Hospital Stays for Patients with Diabetes, 2008.