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Diabetes-related preventable hospitalizations dropped 35%.

SAN DIEGO -- The rate of diabetes-related, potentially preventable hospitalizations in the United States fell by 35% between 1994 and 2002, Michael M. Engelgau, M.D., reported at a press briefing during the annual scientific sessions of the American Diabetes Association.

The rate of these hospitalizations refers to the number of admissions per total number of people with diabetes in the United States.

Although the exact cause of the reduction was not studied, the declines in hospitalizations "are representative of good care," said Dr. Engelgau, associate director for prevention policy in the division of diabetes translation at the Centers for Disease Control and Prevention.

"This could be [because] the diabetic population is growing very quickly in the United States," he suggested. "Maybe it's a slightly healthier population [with diabetes that] doesn't need hospitalization quite as much. Or there could be changes in some of the hospitalization practices in the various health care systems in the United States. Some of these factors are coming into play. We can't say exactly how important those are, but the bottom line is that this does seem to be a very positive trend in these types of potentially preventable hospitalizations."

To study the number of preventable hospitalizations, Dr. Engelgau and his associates used the Healthcare Cost and Utilization Project National Inpatient Sample from 1994-2002. This sample consists of about 80% of all hospitalizations in 35 states and is weighted to represent the entire nation.

The researchers zeroed in on four conditions that can be avoided with high-quality outpatient care, or can be less severe if treated early and correctly: uncontrolled diabetes, short-term complications such as diabetic ketoacidosis, long-term complications such as chronic kidney disease, and lower extremity amputations.

Between 1994 and 2002, the number of diabetes-related preventable hospitalizations in the United States increased from 439,000 in 1994 to 473,000 in 2002. Total costs for these hospitalizations increased from $4 billion in 1994 to $9.5 billion in 2002.

During the same time period, the number of people with diagnosed diabetes increased from 8.1 million in 1994 to 13.3 million in 2002. As a result, the rate of diabetes-related preventable hospital admissions decreased from 55 per 1,000 people with diabetes to 36 per 1,000 people with diabetes, a decline of 35%.

Of the four diabetes-related conditions studied, admission rates for uncontrolled diabetes had the largest decline, from 10 per 1,000 people with diabetes in 1994 to 4 per 1,000 people with diabetes in 2002. The hospital admission rate for long-term complications also had a large decline, from 28 per 1,000 people with diabetes in 1994 to 20 per 1,000 people with diabetes in 2002.

BY DOUG BRUNK

San Diego Bureau
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Title Annotation:Endocrinology
Author:Brunk, Doug
Publication:Internal Medicine News
Geographic Code:1USA
Date:Jul 15, 2005
Words:453
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