Open Access糖尿病相关急诊就诊后住院可能性的影响因素:区域和城乡分析
Author(s) -
Ferdinand Alva O.,
Akinlotan Marvellous A.,
Callaghan Timothy,
Towne Samuel D.,
Bolin Jane N.
Publication year - 2020
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.13066
Subject(s) - medicine , emergency department , diabetes mellitus , census , odds , odds ratio , ethnic group , pacific islanders , demography , population , gerontology , health equity , cross sectional study , emergency medicine , family medicine , logistic regression , environmental health , public health , nursing , pathology , sociology , anthropology , endocrinology
Background The objective of this study is to examine place‐based and individual‐level predictors of diabetes‐related hospitalizations that stem from emergency department (ED) visits. Methods We conducted a pooled cross‐sectional analysis of the National Inpatient Sample (NIS) for 2009 to 2014 to identify ED‐initiated hospitalizations that were driven by the need for diabetes care. The odds of an ED‐initiated diabetes‐related hospitalization were assessed for the United States as a whole and separately for each census region. Results Nationally, residents of noncore areas (odds ratio [OR] 1.10; CI 1.08, 1.12), the South (OR 8.03; CI 6.84, 9.42), Blacks (OR 2.49; CI 2.47, 2.52), Hispanics (OR 2.32; CI 2.29, 2.35), Asians or Pacific Islanders (OR 1.20; CI 1.16, 1.23), Native Americans (OR 2.18; CI 2.10, 2.27), and the uninsured (OR 2.14; CI 2.11, 2.27) were significantly more likely to experience an ED‐initiated hospitalization for diabetes care. Census region‐stratified models showed that noncore residents of the South (OR 1.17; CI 1.14, 1.20) and Midwest (OR 1.06; CI 1.02, 1.11) had higher odds of a diabetes‐related ED‐initiated hospitalization. Conclusions As continued efforts are made to reduce place‐based disparities in diabetes care and management, targeted focus should be placed on residents of noncore areas in the South and Midwest, racial and ethnic minorities, as well as the uninsured population.