PMID- 26167779
OWN - NLM
STAT- MEDLINE
DCOM- 20161213
LR  - 20161230
IS  - 1936-2692 (Electronic)
IS  - 1088-0224 (Linking)
VI  - 21
IP  - 5
DP  - 2015 May 1
TI  - Medicaid-insured and uninsured were more likely to have diabetes emergency/urgent 
      admissions.
PG  - e312-9
AB  - OBJECTIVES: To evaluate the associations between potentially avoidable 
      diabetes-related emergency/urgent hospital admissions and different health 
      insurance status (ie, Medicaid, Medicare, uninsured, private), along with other 
      characteristics including sociodemographic status (age, race/ethnicity, gender, 
      region), hospitalization status (previous hospitalizations, weekend admissions), 
      and health status (complications, comorbidities), among patients with type 2 
      diabetes mellitus (T2DM). STUDY DESIGN: The 2011 data set of all inpatient 
      discharge records with a primary diagnosis of T2DM from all hospitals in 
      Pennsylvania were included in the analyses. METHODS: Multivariable logistic 
      regression modeling with diabetes-related emergency/urgent hospitalizations as 
      the dependent outcome variable and health insurance status as the main exposure 
      independent variable, adjusting for age, race/ethnicity, gender, region, previous 
      hospitalizations, weekend admissions, complications, and comorbidity. Hosmer and 
      Lemeshow goodness-of-fit test was used for logistic model fit analysis. RESULTS: 
      Nearly 91% of 17,097 potentially avoidable diabetes-related hospitalizations were 
      emergency/urgent admissions for T2DM patients in Pennsylvania during 2011. 
      Uninsured and Medicaidinsured patients were 2.1 (adjusted odds ratio [AOR], 2.11; 
      95% CI, 1.23-3.61) and 1.8 (AOR, 1.78; 95% CI, 1.44-2.20) times more likely than 
      privately insured patients, respectively, to be admitted through emergency/urgent 
      admissions. There was no statistically significant difference in emergency/urgent 
      admissions between Medicaid and uninsured (AOR, 0.85; 95% CI, 0.49-1.47). 
      CONCLUSIONS: Medicaid-insured T2DM patients, like the uninsured, are more likely 
      to be hospitalized through emergency/urgent admissions. The presumption that 
      insured individuals with diabetes are more likely than the uninsured to manage 
      and control the progression of their condition, and receive care in the right 
      setting, is not supported for those with Medicaid coverage.
FAU - Fisher, Monica A
AU  - Fisher MA
FAU - Ma, Zheng-qiang
AU  - Ma ZQ
AD  - Pennsylvania Department of Health, Bureau of Epidemiology, 625 Forster St, 
      Harrisburg, PA 17120. E-mail: zma@pa.gov.
LA  - eng
GR  - DP09-9010301PPHF11/DP/NCCDPHP CDC HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20150501
PL  - United States
TA  - Am J Manag Care
JT  - The American journal of managed care
JID - 9613960
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Diabetes Mellitus, Type 2/*epidemiology
MH  - Emergency Service, Hospital/*statistics & numerical data
MH  - Female
MH  - Health Status
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Male
MH  - Medicaid/*statistics & numerical data
MH  - Medically Uninsured/*statistics & numerical data
MH  - Middle Aged
MH  - Pennsylvania
MH  - Residence Characteristics
MH  - Retrospective Studies
MH  - Sex Factors
MH  - Socioeconomic Factors
MH  - United States
EDAT- 2015/07/15 06:00
MHDA- 2016/12/15 06:00
CRDT- 2015/07/14 06:00
PHST- 2015/07/14 06:00 [entrez]
PHST- 2015/07/15 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
AID - 86193 [pii]
PST - epublish
SO  - Am J Manag Care. 2015 May 1;21(5):e312-9.