The occurrence of diabetes and its associated complications has diabetes are Diabetes is a deficiency of insulin or a decrease in the body’s …
Diabetes Hospitalization Report
Illinois Health Care Cost Containment Council
For the Year 2000
Report Number: 2001-5/21-01
DIABETES HOSPITALIZATION
FORWARD
The Illinois Health Care Cost Containment Council was established in 1984 to provide a comprehensive picture of the health care system in the State The Council was created to provide hospitals, health plans and citizens with meaningful information and comparative data about illnesses that require hospitalization Since the Council must consider the role of hospitals in the health care delivery system, we develop reports on topics to assess the impacts of disease conditions on hospital costs and use, and to evaluate the health status of the population The occurrence of diabetes and its associated complications has increased steadily over the past decade The National Institutes of Health and the Centers for Disease control have identified diabetes as a significant public health challenge Approximately 800,000 new cases are diagnosed each year in the United States The Illinois Department of Public Health estimates that approximately 500,000 persons 18 years of age or older have been diagnosed with the disease in Illinois As the
population ages, an increase in the number of people who are at risk for diabetes and who will eventually develop this disease can be expected Individuals with diabetes are at increased risk for heart disease, blindness, kidney failure and lower extremity amputations Diabetes is the leading cause of non-traumatic lower extremity amputations
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Diabetes Hospitalization Report
What is diabetes?
Diabetes is a deficiency of insulin or a decrease in the bodys ability to use insulin Insulin, a hormone secreted by the pancreas, allows glucose sugar to enter body cells and be converted to energy Uncontrolled diabetes results in glucose and lipids fats remaining in the bloodstream and can result in damage to the bodys vital organs as well as contribute to heart disease Diabetes is a serious heath concern that can be associated with severe complications It can lead to work loss, disability and premature death In addition, diabetes exacts a heavy toll on the resources of the health care delivery system For people with diabetes, the key to a healthy life is to follow prescribed treatment plans involving nutrition, exercise and medication In order
to help provide access to diabetic supplies and appropriate education to manage diabetes, Governor George H Ryan signed into law PA 90-0741 This Act amends the state insurance code and requires that insurers provide coverage for diabetic supplies and self-management training and education in outpatient settings Because this law became effective in January 1999, the Council conducted this analysis to serve as a benchmark with which to compare the impact of the Act on reducing hospitalizations for diabetes
Data Notes:
This report examines hospitalizations where the discharge occurred between January 1, 2000 and December 31, 2000, and January 1, 1995 and December 31, 1995 The following ICD-9-CM International Classification of Diseases, Ninth Revision, Clinical Modification were used to identify hospitalizations with a diagnosis of diabetes: 250 x y where x 0,1,2,3,4,5,6,7,8,9 and y 0,1,2,3 Cases are reported whenever these codes are present among the discharge diagnoses whether diabetes appears as a principal or secondary diagnosis The data for this report reflect hospitalizations, not persons If an individual was hospitalized during the study period on 2 separate occasions, the
individual would be counted twice in this report This report was researched and authored by the Councils Office of Health Care Information, which can be contacted at 217/786-7001, 4500 South Sixth Street Road, Suite 194, Springfield, Illinois
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Diabetes Hospitalization Report
Key Findings:
Diabetes accounted for 142 of total hospital discharges in 2000 One out of every seven hospital discharges were diabetes related Hospitalizations for diabetes are on the rise From 1995 2000, hospitalizations with a diagnosis of diabetes increased by 30
While patients are discharged from the hospital one day sooner in 2000 than in 1995, the average charges for hospital services have increased to 17,238 per discharge in 2000 from 14,288 in 1995
91 of diabetes hospitalizations document the presence of diabetes as a secondary diagnosis The elderly are more likely to be hospitalized for diabetes or related conditions Persons 60 years and over accounted for 686 of discharges related to diabetes
Medicare and Medicaid are billed for over half of all diabetes related hospitalizations — 52
Hospitalizations with a Diabetes Diagnosis
14
Hospitalizations without a Diabetes Diagnosis 86
One out of every seven hospitalizations
231,701 with a diabetes diagnosis 1,404,860 without a diabetes diagnosis 1,636,561 total hospitalizations in Illinois during 2000
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What is the Impact of Diabetes on Hospital Services ?
The number of discharges per year increased between 1995 and 2000 while the average length of stay decreased by 1 full day since 1995 However, average and total charges for care rise
Hospitalizations with Diabetes as Principal or Secondary Diagnosis
Hospital Discharges Hospital Days Average Length of Stay in Days Total Hospital Charges Average Charges per Case
1995 177,607 1,178,625 663 2,537,683,072 14,288
2000 231,701 1,281,625 553 3,994,124,861 17,238
Change over Time 305 87 -11 days 574 20,6
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How Do Hospitalizations for Diabetes Differ?
Diabetes as a Secondary Diagnosis Those without a Diabetes Diagnosis
910
860
140
90
Those with a Diabetes Diagnosis Diabetes as a Principal Diagnosis
Out of 231,701 hospitalizations with a diabetes diagnosis, 20,728 91 listed diabetes as a principal diagnosis,
suggesting that the reason for the hospitalization was a direct result of diabetes The remaining 210,973 91 hospitalizations listed diabetes as a secondary diagnosis Diabetes may or may not be the cause of these hospitalizations but they can be the result of long-term complications of diabetes such as renal or heart disease
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How Have Hospitalizations for Diabetes Changed Over the Past Few Years?
Hospitalization Rate for Diabetes -Principal or Secondary Diagnosis
Per 1,000 IL Residents
1501 20 10 0
1995 2000
1871
In 2000 nearly 19 discharges for every 1000 residents in Illinois were due to diabetes From 1995 to 2000, hospitalizations with a diagnosis of diabetes increased 305 over 54,000
1995 Number of Discharges 177,607 2000 Number of Discharges 231,701
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How Have Hospitalizations with Diabetes as a Principal Diagnosis Changed Over the Past Few Years?
Hospitalization Rate for Diabetes as A Principal Diagnosis Only
Per 1000 Il Residents
167 168 166 164 162 16
1995
2000
163
The hospitalization rate for diabetes as the principal diagnosis was virtually steady between 1995 and
2000
1995 Number of Discharges 19,286 2000 Number of Discharges 20,728
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How Have Hospitalizations with Diabetes as a Secondary Diagnosis Changed Over the Past Few Years?
Hospitalization Rate for Diabetes Secondary Diagnosis Only
Per 1,000 Il Residents
1703 20 15 10 5 0
1995 2000
133
However, the hospitalization rate for diabetes as a secondary diagnosis increased 333 between 1995 and 2000 This increase suggests a high rate of illness due to the comorbidities and complications of the disease
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Diabetes-related Hospitalizations
Hospitalizations with diabetes as a secondary diagnosis are important because they provide an overall picture of the reasons for hospitalizations that can be related to diabetes Some of the major reasons for hospitalization include the long-term complications of diabetes The following chart shows, by body system why people with a secondary diagnosis of diabetes are hospitalized Conditions associated with these body systems account for 741 of all hospitalizations where diabetes is a secondary diagnosis Reasons for Hospitalization
Circulatory System
Respiratory System Digestive System Nervous System Musculoskeletal System Kidney and Urinary Tract TOTAL All Other Major Diagnostic Categories 2000 70,043 25,392 18,159 16,261 15,527 11,088 156,470 54,503 cumulative percent 33 33 12 45 9 54 8 62 7 69 5 74 74 26 100
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Lower Extremity Amputations
Hospitalization Rate for Lower Extremity Amputations, by Year
Per 10,000 Il Residents
289 29 279 285 28 275 27
1995 2000
1995 Number of Discharges 3,304 2000 Number of Discharges 3,566
In 2000, there were nearly three occurrences of lower extremity amputations for every 10,000 residents in Illinois
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Who Pays for Diabetes Hospitalizations??
Medicare and Medicaid are the expected primary payment source for 52 of all diabetes-related discharges in 2000 All other sources accounted for 22, while commercial insurers were charged 21 of total diabetes charges in Illinois — a total exceeding 399 billion
All Other Sources 22 HMO 5 Commercial 21
Medicare 35
Medicaid 17
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How Do Hospitalizations for Diabetes Differ By Age Group?
In calendar year
2000, patients over 60 accounted for 68 of the hospitalizations for diabetes The largest share belonged to those in the age 70-79 age bracket, which led all with 283 The second largest number occurred with the age 60-69 group, which had 217 of the diabetes hospital cases
Hospitalizations for Diabetes by Age
03
283
025
217
184 02 157
015 93 01
389 005 020 071 157
0 Age 0-9 Age 10-19 Age 20-29 Age 30-39 Age 40-49 Age 50-59 Age 60-69 Age 70-79 Age 79
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How Do Hospitalizations for Diabetes Differ By Age Group?
Hospitalization Rate for Diabetes, by Age Comparsion between 1995 and 2000-
Per 1,000 IL Residents
5066
1995 1999
3902 3254
6 5
2744 3519 1597
4367 4 2538 2200 3 2 1 0
-6 -7
0683 0035 0125 0280 0660
9 9 -4 -5 9 70 9 A ge 79 9 9 A ge
1295
0034
9 0ge
0124
9 -1 10
0276
-3 -2 20 30 40 50 60 A ge
ge
ge
ge
ge
A
NOTE — Calendar Year 2000 population estimates by age unavailable
A
A
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A
A
A
ge
How Do Hospitalizations for Diabetes Differ by Gender?
Hospitalization Rates for Diabetes, by Gender Per 1,000 Ill Residents
960 1514 761 1217 Female 2000 Female
1995 Male 2000 Male 1995
000
200
400
600
800
1000
1200
1400
1600
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Diabetes Hospitalization Report
Recommendations:
Further action is needed at the State and local levels to reduce the impact of diabetes on Illinois residents Diabetes education and management training programs should be encouraged among diabetics, especially people over 60 years of age to reduce the disease burden The impact of diabetes on hospitalizations should be assessed regularly to evaluate the effectiveness of state mandated insurance coverage requirements
160 N LaSalle St Suite S-200 Chicago, Il 60601 Phone 312/793-1440 Fax 312/793-7963
4500 South 6th Street Road Suites 194 215 Springfield, Il 62703 Phone 217/786-7001 Fax 217/786-7481
Toll Free Health Care Hotline 1-866-847-3246
Illinois Health Care Cost Containment Council 15
George H Ryan Governor Lenell Gwin-Beaty Executive Director
Frank Gramm, Chairman TrustMark Insurance Company, Lake Forest, Illinois Malcolm P Chester, Vice Chairman MPC Consulting, Chicago Cheryl L Segal, Secretary Hogan, Marren, McCahill-Ltd, Chicago James C Chao Metro Provider Service Corp, Naperville, Illinois Lois
Frels, PhD Frels and Associates Consulting, Hillsdale, Illinois Jay Kiokemeister, DO, MPH Illinois Freestanding Surgical Treatment Centers Association, Chicago Jim Kowalczyk Illinois Hospital Association, Naperville, Illinois Edward Leary, MD, MBA Humana Inc, Chicago Michael Pittman PitGam Enterprises, Inc, Springfield Andrew Melczer, PhD Illinois State Medical Society, Chicago Irv Smith State of Illinois Administrator Retired, Springfield Larry Swearingen Blessing Hospital, Quincy, Illinois William W Tipton, Jr MD American Academy of Orthopedic Surgeons, Rosemont, Illinois
Printed by Authority of the State of Illinois
Illinois Health Care Cost Containment Council
Source:hsph.harvard.edu
