Relationship of diabetes with cardiovascular disease-related hospitalization rates, length of stay, and charges: Analysis by race/ethnicity, age, and sex

Objective: Determine relationship of diabetes with risk of cardiovascular disease hospitalizations and the effect on hospital length of stay and charges. Design: A cross-sectional analysis of Georgia hospital discharge data for 1998 through 2001. Patients: Patients hospitalized principally with one of six cardiovascular disease (CVD) conditions (myocardial infarction, ischemic heart disease, cardiac dysrhythmia, heart failure, cerebrovascular events, peripheral vascular disease) were identified in the hospital dis-charge data. Main Outcome Measures: Aggregated CVD-related hospitalization rates, length of stay, and charges were compared by presence of diabetes. Analyses were adjusted for age, sex, and race/ethnicity. Results: A total of 3,900,337 discharges were recorded between 1998 to 2001. Of these, 468,957 discharges (12%) had one of the six selected CVD diagnoses (average age 67 years, average length of stay 4.7 days, average total charge $15,702, 48% women, 76% non-Hispanic Whites, 22% non-Hispanic Blacks, and 1% Hispanics). Diabetes was a concurrent diagnosis in 30% of these CVD-related discharges. CVD hospitalization rates were significantly higher and length of stay and total charges were significantly greater among non-Hispanic Whites and Blacks - but not in Hispanics - with diabetes compared to persons without diabetes. Diabetes had a similar effect on CVD hospitalizations among men and women, but the effect of diabetes was lessened with increasing age. Conclusion: These data suggests that aggressive outpatient modification of metabolic abnormalities in diabetes patients should be attempted to decrease risk of CVD-related hospitalization and lower the economic impact of these combined conditions.