Length of Stay and Deaths in Diabetes-Related Preventable Hospitalizations Among Asian American, Pacific Islander, and White Older Adults on Medicare, Hawai‘i, December 2006–December 2010

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Guo, Mary W. ; Ahn, Hyeong Jun ; Juarez, Deborah T. ; Miyamura, Jill ; Sentell, Tetine L.
• Description:
  Introduction
  
  The objective of this study was to compare in-hospital deaths and length of stays for diabetes-related preventable hospitalizations (D-RPHs) in Hawai‘i for Asian American, Pacific Islander, and white Medicare recipients aged 65 years or older.
  
  Methods
  
  We considered all hospitalizations of older (>65 years) Japanese, Chinese, Native Hawaiians, Filipinos, and whites living in Hawai‘i with Medicare as the primary insurer from December 2006 through December 2010 (n = 127,079). We used International Classification of Diseases – 9th Revision (ICD-9) codes to identify D-RPHs as defined by the Agency for Healthcare Research and Quality. Length of stays and deaths during hospitalization were compared for Asian American and Pacific Islander versus whites in multivariable regression models, adjusting for age, sex, location of residence (Oahu, y/n), and comorbidity.
  
  Results
  
  Among the group studied, 1,700 hospitalizations of 1,424 patients were D-RPHs. Native Hawaiians were significantly more likely to die during a D-RPH (odds ratio [OR], 3.92; 95% confidence interval [CI], 1.42–10.87) than whites. Filipinos had a significantly shorter length of stay (relative risk [RR], 0.77; 95% CI, 0.62–0.95) for D-RPH than whites. Among Native Hawaiians with a D-RPH, 59% were in the youngest age group (65–75 y) whereas only 6.3% were in the oldest (≥85 y). By contrast, 23.2% of Japanese were in the youngest age group, and 32.2% were in the oldest.
  
  Conclusion
  
  This statewide study found significant differences in the clinical characteristics and outcomes of D-RPHs for Asian American and Pacific Islanders in Hawai‘i. Native Hawaiians were more likely to die during a D-RPH and were hospitalized at a younger age for a D-RPH than other studied racial/ethnic groups. Focused interventions targeting Native Hawaiians are needed to avoid these outcomes.
  
  
• Subjects:
  Aged Aged, 80 And Over Asian Diabetes Complications/ethnology Diabetes Complications/prevention & Control Ethnicity Female Hospitalization Hospital Mortality/ethnology Humans International Classification Of Diseases Length Of Stay Male Medicare Multivariate Analysis Native Hawaiian Or Other Pacific Islander White People

  More +
• Source:
  Prev Chronic Dis. 12.
• DOI:
  http://dx.doi.org/10.5888/pcd12.150092
• ISSN:
  1545-1151
• Pubmed ID:
  26247424
• Pubmed Central ID:
  PMC4552136
• Document Type:
  Journal Article
• Funding:
  G12 MD007601/MD/NIMHD NIH HHS/United States ; G12MD007601/MD/NIMHD NIH HHS/United States ; P20 MD000173/MD/NIMHD NIH HHS/United States ; P20GM103466/GM/NIGMS NIH HHS/United States ; R01HS019990/HS/AHRQ HHS/United States ; U54 MD007584/MD/NIMHD NIH HHS/United States ; U54MD007584/MD/NIMHD NIH HHS/United States
• Place as Subject:
  Hawaii ; United States
• Volume:
  12
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:f17f9691ee6e4ec05eb0730ba627b7028c46ddba28600ac3bbfdc9d4c12c2886d1da47b79b1eeb484f352168f00ee15f080fe815aa082b6139d7da02deb0df97
• Download URL:
  https://stacks.cdc.gov/view/cdc/34224/cdc_34224_DS1.pdf
• File Type:
  [PDF - 297.48 KB ]