Use of a Publicly Available Database to Determine the Impact of Diabetes on Length of Hospital Stay for Elective Orthopedic Procedures in California

Abstract

In California, 1 in 3 hospital beds are occupied by adults with diabetes. The aim of this study was to examine whether diabetes impacts length of stay (LOS) following common elective orthopedic procedures compared to nondiabetic individuals, and also the performance of hospitals across California for these procedures. Using the Public Use California Patient Discharge Data Files for 2010-2012, the authors examined LOS for elective discharges for hip, spine, or knee surgery (n = 318,861) from the total population of all discharges (n = 11,476,073) for 309 hospitals across California. In all, 16% of discharges had a codiagnosis of diabetes. Unadjusted average LOS was 3.11 days without and 3.40 days with diabetes (mean difference 0.29 [95% confidence interval (0.27, 0.31) days, P < 0.01]). After adjusting for covariates, diabetes no longer resulted in a significant difference in LOS. However, the presence of common comorbidities did significantly impact LOS. Average LOS for patients with diabetes also varied widely by hospital, ranging between -50% and +100% of the mean LOS for all hospitals. Diabetes does not prolong LOS after orthopedic procedures unless comorbidities are present. Nevertheless, across California there is significant variation in LOS between individual hospitals, which may inform the decision-making process for prospective patients and payers.

Predominantly negative impact of diabetes on spinal surgery: A review and recommendation for better preoperative screening

“…[1027] Kerr et al . (2016) found 1 of 3 hospitalized adults in California (CA) had DM; this did not significantly increase LOS for elective general orthopedic surgery [Table 3].…”

“…(2016) found 1 of 3 hospitalized adults in California (CA) had DM; this did not significantly increase LOS for elective general orthopedic surgery [Table 3]. [10] Of 11,476,073 discharges from 309 CA hospitals, DM did not significantly increase LOS following hip, spine, or knee surgery ( n = 318,861 patients). The Public Use California Patient Discharge Data Files (CPDDF) (2010-2012) showed 16% of discharges included a diagnosis of diabetes; however, the average LOS was comparable with (3.40 days with DM) vs. without DM (3.11 days without DM).…”