title: Public cost and access to primary care for hyperglycemic emergencies, Clark County, Nevada.
abstract: Diabetes mellitus accounts for 5.8% of the total health care costs of citizens of the United States. Hospitalization expenses produce 40.5% of these costs. We sought to determine the public expenditure and major precipitators of admissions for uninsured diabetic hyperglycemic emergencies at a large public hospital. Of 247 diabetic emergency admissions over a 30 month period 49% (n = 121) of these patients had no medical insurance. The uninsured patients were younger and had relatively mild disease in comparison to the insured patients. These patients identified a primary physician in only 6% of the cases and had a higher incidence of admissions associated with lack of medications. We conclude that public funds to provide access to primary care and enhancement of employer-sponsored health insurance programs may decrease the numbers and costs of hospitalizations due to hyperglycemic emergencies in uninsured patients with diabetes mellitus.
authors.affiliation: University of Nevada School of Medicine, Las Vegas, USA.
authors.forename: B E
authors.initials: BE
authors.lastname: Wilson
authors.forename: A
authors.initials: A
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D003920:Diabetes Mellitus / Q000191:economics; D016883:Diabetic Ketoacidosis / Q000191:economics* / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000191:economics; D017722:Hospital Charges; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000191:economics* / Q000453:epidemiology; D017057:Medically Uninsured; D008875:Middle Aged; D009505:Nevada / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies