title: Hospitalization of patients with diabetes.
abstract: To determine annual hospitalization rates for patients with diabetes mellitus, we retrospectively analyzed the frequency of hospitalization among 905 patients with diabetes receiving primary care in a private practice outpatient program during a 20-month period (1,508 patient-years). We assessed the annual hospitalization rates stratified by diabetes clinical severity index, type of diabetes, type of treatment, age, sex, and mean glycosylated hemoglobin. The all-cause annual hospitalization rate was 211 per 1,000 patients (95% confidence interval, 184 to 238). Hospitalization rates were strongly correlated with measures of clinical severity; hospitalization rates did not vary significantly with type of diabetes, age, or sex. Among patients with type II diabetes, rates were higher in the group treated with insulin. A trend was noted for hospitalization rates to increase with mean glycosylated hemoglobin (not statistically significant in this sample). Overall, 14% of hospitalizations were for metabolic reasons, 45% were related to clinical complications of diabetes, and 41% were unrelated to the presence of diabetes. In analysis of hospitalization rates and therefore health-care expenditures for patients with diabetes, the characteristics of the patient population--and especially measures of clinical severity--must be considered. Interventions to reduce hospitalization can be targeted at high-risk groups.
authors.affiliation: Department of Medicine, Vanderbilt University School of Medicine, and St. Thomas Hospital, Nashville, Tennessee, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Graber
authors.forename: F A
authors.initials: FA
authors.lastname: Davidson
authors.forename: M S
authors.initials: MS
authors.lastname: Brown
authors.forename: J A
authors.initials: JA
authors.lastname: Gaume
authors.forename: M D
authors.initials: MD
authors.lastname: McRae
authors.forename: K
authors.initials: K
authors.lastname: Wolff