Diabetes-related hospital mortality in the U.S.: A pooled cross-sectional study of the National Inpatient Sample |
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Authors: | Alva O. Ferdinand Marvellous A. Akinlotan Timothy Callaghan Samuel D. Towne Jr Jane Bolin |
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Affiliation: | 1. Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX, United States of America;2. Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, TX, United States of America;3. Department of Health Management and Informatics, University of Central Florida, Orlando, FL, United States of America;4. Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, United States of America |
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Abstract: | AimsDespite advancements in the diagnosis and treatment of diabetes in the U.S., place-based disparities still exist. The purpose of this study is to determine place-based and other individual-level variations in diabetes-related hospital deaths.MethodsA pooled cross-sectional study of the 2009–2015 National Inpatient Sample was conducted to examine the odds of a diabetes-related hospital death. The main predictors were rurality and census region. Individual-level socio-demographic factors were also examined.ResultsApproximately 1.5% (n?=?147,069) of diabetes-related hospitalizations resulted in death. In multivariable analysis, the odds of diabetes-related hospital deaths increased across the urban-rural continuum, except for large fringe metropolitan areas, with the highest odds of such deaths occurring among residents of micropolitan (OR?=?1.16, 95% C.I.?=?1.14, 1.18) and noncore areas (OR?=?1.21, 95% C.I.?=?1.19, 1.24). Compared to residents of the Northeast, residents in the South, West and Midwest regions were significantly more likely to experience a diabetes-related hospital death. Asian or Pacific Islanders, Medicaid-covered patients and the uninsured were also more likely to die during a diabetes-related hospitalization.ConclusionsPlace-based disparities in diabetes-related hospital deaths exist. Targeted focus should be placed on the control of diabetic complications in the South, West and Midwest census regions, and among rural residents. |
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Keywords: | Diabetes Disparities Population health Census regions Rurality Mortality |
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