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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
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Details:
  • Pubmed ID:
    26247424
  • Pubmed Central ID:
    PMC4552136
  • 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.

  • Document Type:
  • Funding:
    G12 MD007601/MD/NIMHD NIH HHS/United States
    G12MD007601/MD/NIMHD NIH HHS/United States
    P20 MD000173/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
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