Impact of Diabetes on Hospitalized Patients With Chronic Medical Conditions

Abstract

OBJECTIVE | To measure cost and length of stay in patients with and without a diagnosis of diabetes admitted with cardiovascular, pulmonary, or cerebrovascular disease. METHODS | A retrospective study usedInternational Classification of Diseases, 10th revision, Clinical Modification, codes to identify patients with diabetes, cardiovascular, pulmonary, or cerebrovascular disease. The All Patients Refined Diagnosis Related Groups, which classify patients according to admission diagnosis, severity of illness, and risk of mortality, were used to determine actual (discharge) diagnoses. Total admission cost and length of stay were compared using the Wilcoxon rank-sum test. RESULTS | The study reviewed 48,572 subjects who met inclusion criteria. When compared with patients without diabetes of similar age, sex, race, risk of mortality, and severity of illness and controlling for length of stay, individuals with diabetes had similar total admission costs. Lengths of stay were similar for individuals with and without diabetes admitted with a diagnosis of cerebrovascular disease or respiratory infection. However, patients with a primary diagnosis of congestive heart failure and a secondary diagnosis of diabetes incurred longer lengths of stay. CONCLUSION | Individuals with diabetes and congestive heart failure have longer lengths of stay than those without diabetes. To decrease the economic burden of diabetes and chronic conditions, primary care providers and hospitals need to implement guidelines regarding the management of care for individuals with two or more chronic conditions.