According to a report released on May 2014 by the UCLA Center for Health Policy Research and the California Center for Public Health Advocacy, one in three hospitalized people age 35 years or more in California has diabetes, which increases the complexity and cost of their care. The report is prepared on the basis of a study which analyzed all 2011 hospital discharge data and annual financial data from the Office of Statewide Health Planning and Development (OSHPD). In the opinion of a study author, diabetes affects most body systems in one way or another and this makes it more challenging to treat the disease. Since this disease also affects the healing ability of the body, its costs go higher.
The major findings mentioned in this report are:
- An extra $1.6 billion dollars adds to hospitalization costs in California every year with hospital stays for patients with diabetes costing nearly $2,200 more than stays for patients without diabetes. As per the study, three-quarters of that care is paid through Medicare or Medi-Cal (California’s health plan for the poor and disabled) with $254 million in costs paid by Medi-Cal alone.
- Though diabetes was found to be the primary cause in only 1.7 percent of all hospitalizations, patients with diabetes have a higher risk for diseases that lead to significant expenses such as kidney and heart disease, blindness and limb amputations. Two third of diabetes patients who were estimated to have had at least one of these complications resulted in around $23 billion in medical costs nationally in 2006.
- Around 60 percent of hospitalizations for diabetes included people aged 65 years of age or more.
- The medical records analyzed during the study showed that ethnic communities are most dramatically impacted by diabetes. Around 43.2 percent of all Latino hospital patients in California aged 35 years or more have diabetes compared to the statewide average of 31 percent. While 40.3 percent of American Indians/Alaska hospital patients have diabetes, 39.3 percent African-Americans and 38.7 percent Asian-Americans/Pacific Islanders have diabetes.
The interesting part of this study is that it found approximately 90-95 percent diagnosed diabetes among adults is type 2 diabetes (associated with obesity and inactive lifestyle) and it is preventable. With early diabetes education and better preventive measures, it is possible to reduce hospitalizations and drive down healthcare costs. The report recommends that policymakers should consider the following options to reduce the surge in healthcare costs related to increasing diabetes cases.
- Promote Appropriate Diabetes Management – With diabetes care guidelines, self-management education and healthcare provider supervision, providers and patients can manage and control diabetes better by controlling blood sugar, blood pressure, and cholesterol levels, taking regular foot exams and dilated eye exams, smoking cessation and weight loss. Diabetes patients can thus avoid costly hospitalizations due to complications.
- Improve Access to Quality Primary and Specialty Care – Lack of continuous health insurance coverage or sufficient benefit packages remains a significant financial barrier to primary and specialty care access. A medical home that encourages good relationship with providers and the healthcare team is also essential to manage diabetes in primary and specialty care settings.
- Encourage Healthy Eating – The food and beverage environment should be improved by expanding access to fruits and vegetables; moreover, the availability of safe and low-cost drinking water needs to be ensured. In addition to this, educational strategies should be developed to improve the knowledge of consumers regarding food and beverage choices.
- Promote Regular Physical Activity – Lack of physical activity can lead to diabetes and obesity and therefore it is very important to promote building environments that encourage regular physical activity (for example, safe parks). Worksite programs that facilitate regular physical activity are also effective options.
Family practice physicians should prepare and maintain the records of their patients accurately so that they can constantly analyze the health status of the patient (for example, how blood sugar, blood pressure, and cholesterol levels vary), give valuable suggestions to reduce diabetes risk and thereby avoid hospitalizations. Accurate clinical documentation is also important from the point of view of medical billing and helps to receive the correct reimbursement in time.