title: Type 2 Diabetes Mellitus Patients' Healthcare Costs Related to Inpatient Hospitalizations: A Retrospective Administrative Claims Database Study.
abstract: BACKGROUND
  Diabetes-related healthcare costs are increasing in the United States, with inpatient hospitalization the largest component of medical expenditures. The aims of this study were to characterize hospitalized type 2 diabetes mellitus (T2DM) patients, understand the relationship between hospitalization and healthcare costs, and explore treatment modification after inpatient hospitalization.
  
  
  METHODS
  A retrospective cohort analysis of Humana Medicare Advantage and commercial members with T2DM was conducted. T2DM members were identified and assigned to three groups: (1) inpatient hospitalization (IPH) without a 30-day readmit (IPH group); (2) IPH with a 30-day readmission (IPH readmission group); and, (3) matched non-IPH group. Demographics, clinical characteristics, comorbidities and healthcare costs were measured based on enrollment data and claims. Descriptive statistics were used and the relationship between IPH and costs was assessed using generalized linear models.
  
  
  RESULTS
  A total of 15,555 IPH patients, 1757 IPH readmission patients, and 17,312 matched non-IPH patients were included in the study. The IPH readmission group had the highest adjusted mean all-cause total costs ($76,806), followed by the IPH group ($42,011), and the non-IPH group ($9624). A similar trend was observed for adjusted all-cause mean medical and pharmacy costs. DM-related total healthcare costs were highest for the IPH readmission group ($13,714), followed by the IPH group ($7477), and non-IPH group ($1620). While overall therapy modification (discontinuation, addition, switch) was low, T2DM patients with an IPH (with or without a readmission) had greater rates of therapy modification relative to the non-IPH patients.
  
  
  CONCLUSIONS
  Adjusted all-cause and DM-related total costs were greatest for IPH readmission patients. Rates of treatment modification within 10 days of discharge after IPH were generally low. Identifying T2DM patients at high risk of readmission and employing methods to decrease that risk during the index hospitalization could have a significant impact on health system costs.
  
  
  BACKGROUND
  Novo Nordisk.
authors.affiliation: Comprehensive Health Insights, Inc., 515 W. Market St., 7th Floor, Louisville, KY, 40202, USA.
authors.forename: Vishal
authors.initials: V
authors.lastname: Saundankar
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Ellis
authors.forename: Elsie
authors.initials: E
authors.lastname: Allen
authors.forename: Tony
authors.initials: T
authors.lastname: DeLuzio
authors.forename: Chad
authors.initials: C
authors.lastname: Moretz
authors.forename: Yunus
authors.initials: Y
authors.lastname: Meah
authors.forename: Brandon
authors.initials: B
authors.lastname: Suehs
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bouchard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000191:economics*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007297:Inpatients; D007345:Insurance Claim Review; D008297:Male; D010359:Patient Readmission; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014481:United States