Avoidable Hospital Admissions From Diabetes Complications In Japan, Singapore, Hong Kong, And Communities Outside Beijing

Quan, Jianchao; Zhang, Huyang; Pang, Deanette; Chen, Brian; Johnston, Janice M.; Jian, Weiyan; Lau, Zheng Yi; Iizuka, Toshiaki; Leung, Gabriel M.; Fang, Hai; Tan, Kelvin B.; Eggleston, Karen

doi:10.1377/hlthaff.2017.0479

Cited by 15 publications

(20 citation statements)

References 13 publications

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“…In our study, more than 25% of insured, community-dwelling Medicare beneficiaries aged 65 or older with type 2 diabetes reported they would avoid going to the doctor. Older adults with diabetes are at risk of potentially preventable acute and chronic diabetes-related complications that could result in unplanned hospitalizations, poor quality of life, and even death ( 12 , 13 ). Consistent with the Behavioral Model of Healthcare Service Use ( 14 , 15 ), we showed that choosing to avoid health care among Medicare beneficiaries with type 2 diabetes is multifactorial, and a result of individual, economic, health care provider, and system-level factors.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Avoiding Health Care Among Community-Dwelling Medicare Beneficiaries With Type 2 Diabetes

LaManna

Towne

et al. 2020

Prev. Chronic Dis.

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Introduction Health care avoidance by Medicare beneficiaries with chronic conditions such as type 2 diabetes can result in adverse health and economic outcomes. The objective of this study was to describe factors associated with choices to avoid health care among Medicare beneficiaries with type 2 diabetes. Methods We used a survey-weighted logistic model and the nationally representative 2016 Medicare Current Beneficiary Survey to analyze data on 1,782 Medicare beneficiaries aged ≥65 with type 2 diabetes, to examine associations between Medicare beneficiaries’ decisions to avoid health care and multiple factors (eg, dissatisfaction with information given by providers, health problems that should have been discussed with providers but were not, worry about health more than other people their age). Results Of our study sample, 26.1% reported they avoid health care. Five factors were associated with avoiding health care: delaying care (vs not) because of costs (adjusted odds ratio [aOR] = 2.06; P = .005); having health problems that should have been discussed with providers but were not (vs having discussions) (aOR = 1.50; P = .04); worrying (vs not) about health more than other people their age (aOR = 2.13; P < .001); self-reporting “other” minority race (vs non-Hispanic White) (aOR = 2.01; P = .006); and education levels. Participants with less than a high school diploma (aOR = 1.95; P = .001) and participants with a high school diploma only (aOR = 1.49; P = .049) were more likely than participants with an education beyond high school to report avoiding health care. Conclusion Approximately 1 in 4 Medicare beneficiaries with type 2 diabetes avoid health care. We found inequities in care-seeking behavior by race/ethnicity and education level. Health care perceptions and lack of appropriate discussion of health care concerns with health care providers are also associated with this behavior. Clinical interventions (eg, improved patient–provider communication) and educational outreach are needed to decrease the numbers of Medicare beneficiaries who avoid health care.

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Section: Discussionmentioning

confidence: 99%

Factors Associated With Avoiding Health Care Among Community-Dwelling Medicare Beneficiaries With Type 2 Diabetes

LaManna

Towne

et al. 2020

Prev. Chronic Dis.

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“…Furthermore, it may be the starting point for the analysis of other PQI rates such as the Chronic Obstructive Pulmonary Disease, Hypertension Admission Rate, among others. Several studies have been conducted and published in the literature regarding PQI, in many approaches, from the simplest to the most complex [ 32 , 47 , 48 , 49 , 50 , 51 , 52 ], that are possible allied methodologies for a more in depth comparative analysis, which can be reinforced and based on this method of identifying areas through their respective quadrants of performance scenarios, still to be performed by our group in Portugal. The analysis of quality indicators related to diabetes in PHC and their association with the variability of the results of preventable hospitalizations, in addition to the efficiency analysis of the resources applied in PHC, are ways to deepen this analysis, either individually in each ACES as per regions.…”

Section: Discussionmentioning

confidence: 99%

Landscapes on Prevention Quality Indicators: A Spatial Analysis of Diabetes Preventable Hospitalizations in Portugal (2016–2017)

Ramalho

Duarte

Souza

et al. 2020

IJERPH

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Preventable hospitalizations due to complications of diabetes mellitus (DM), represented by the related prevention quality indicators (PQI), are ambulatory care-sensitive conditions that can be prevented and controlled through effective primary health care (PHC) treatment. It is important to reduce mortality and promote the quality of life to diabetic patients in regions with higher hospitalization rates. The study aims to analyze the results of the DM age-sex-adjusted PQI, by groups of health centers (ACES), distributed in the Portuguese territory. The most representative PQI at a national level were identified, and the trends were mapped and analyzed. Also, it presents the ACES with the highest age-adjusted rates of avoidable hospitalizations for DM. The absolute number of preventable hospitalizations for all DM complications in Portugal has decreased by 20%, thus passing from the rate of 79 in 2016 to 65.2/100,000 inhabitants in 2017. Despite the improvement in results for PQI 03, 20 of 48 ACES that were above the national 2017 median rate in 2016, achieved better results the following year, and for the overall preventable diabetes hospitalizations (PQI 93) only 11 out 39, revealing the need for further studies and PHC actions to improve the diabetic quality of life.

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“…In other studies, the primary health care quality indicators published by the OECD were employed to identify avoidable hospitalizations for diabetes, and the avoidable hospitalization rate was estimated for those diagnosed with diabetes (i.e., the number of diabetes-related avoidable hospitalizations in a given year divided by the number of people diagnosed with diabetes in the same location and year). As reported by the study, the avoidable hospitalization rate per 1000 patients suffering from diabetes in 2012–14 in Japan was 23.3, 36.2 in Singapore and 42.5 in Hong Kong [ 15 ]. Several studies were conducted on individual avoidable hospitalizations; for instance, the avoidable hospitalization rate of uncomplicated hypertension was 3.7 per 1000 hypertensive patients in four Canadian provinces and territories [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some other studies measured using information from only a few hospitals [ 20 ]. There have been rare analyses on trends in avoidable hospitalization rates and treatment costs, and the only analyses that have been conducted have used older data [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Trends in avoidable hospitalizations in a developed City in eastern China: 2015 to 2018

Chen

Jian

2022

BMC Health Serv Res

Self Cite

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Objective This study aimed to measure the avoidable hospitalization rate and the treatment cost per hospitalization in large cities of eastern China. Methods In this study, the hospital discharge data of all inpatients in the city from 2015 to 2018 were collected. In accordance with the organization for Economic Cooperation and Development (OECD) definition of avoidable hospitalizations, five diseases were selected as the measurement objects, including hypertension, diabetes, asthma, chronic obstructive pulmonary disease (COPD), as well as congestive heart failure (CHF). We described the avoidable hospitalization rate, average cost and length of stay for avoidable hospitalization cases. Linear probability model and log-linear model were used to control the basic characteristics and disease severity of patients, and to measure the trend of the avoidable hospitalization rate and expenditure of avoidable hospitalizations. Results From 2015 to 2018, the absolute number of avoidable hospitalizations in the city increased while fluctuating, which reached 125,372 in 2018. Among the five avoidable hospitalizations, the number of hospitalizations for diabetes increased continuously in the 4-year period. Congestive heart failure showed the most significant increase over the four years. Avoidable hospitalizations in the city have remained at a high level, while avoidable hospitalizations of hypertension and asthma fell to levels lower than those in 2015 in 2017 and 2018 after rising in 2016. The cost per hospitalization and length of stay per hospitalization decreased. Conclusions Avoidable hospitalizations in the city remain at a high level, and more effective policies should be formulated to guide patients with avoidable hospitalizations, so as to more effectively exploit outpatient services and continuously improve the quality of primary health care services.

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Avoidable Hospital Admissions From Diabetes Complications In Japan, Singapore, Hong Kong, And Communities Outside Beijing

Cited by 15 publications

References 13 publications

Factors Associated With Avoiding Health Care Among Community-Dwelling Medicare Beneficiaries With Type 2 Diabetes

Factors Associated With Avoiding Health Care Among Community-Dwelling Medicare Beneficiaries With Type 2 Diabetes

Landscapes on Prevention Quality Indicators: A Spatial Analysis of Diabetes Preventable Hospitalizations in Portugal (2016–2017)

Trends in avoidable hospitalizations in a developed City in eastern China: 2015 to 2018

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