OBJECTIVES: Preventable diabetes-related hospitalization is an indicator of the timely diagnosis and management of Type 2 Diabetes Mellitus (T2DM). The Agency for Healthcare Research & Quality has endorsed the prevention quality indicator 93 (PQI93) for preventable diabetes admissions. This study aims to estimate the rate of preventable diabetes-related hospitalizations in a population of Medicaid enrollees, and to explore the county-level variation in the rate of preventable diabetes-related hospitalizations within Mississippi Medicaid.

METHODS: A retrospective analysis was conducted using 2014 National Medicaid administrative claims from 17 states (CA, GA, ID, IA, LA, MI, MN, MS, MO, NJ, PA, SD, TN, UT, VT, WV, WY). The rate of preventable hospitalizations was measured using PQI93. PQI93 was identified as the proportion of beneficiaries with diabetes admissions for any of the following conditions: diabetes with short-term complications, long-term complications, lower-extremity amputation, and uncontrolled diabetes without complications among beneficiaries ages 18 years and older.

RESULTS: The national PQI93 rate was 2.88% among all enrolled adults. Among adult males and females, the rate was 2.74% vs 3.09%, respectively. PQI93 was higher among Hispanics (3.98%) and Blacks (2.77%), compared to Whites (2.34%). The highest PQI93 was observed in Missouri (4.63%), followed by South Dakota (3.90%), and Mississippi (3.75%), while the lowest PQI93 was observed in Vermont (1.35%). The state of Mississippi ranked as one of the states with the highest PQI93 which was higher than the national average. The PQI93 was highest in the Delta region compared to the other regions in Mississippi. The relationship between known social determinants of health and PQI93 will also be evaluated.

CONCLUSIONS: The national PQI93 was 2.88% in 2014. Mississippi showed a higher rate of preventable hospitalization than the national average. Counties in the Delta region showed higher PQI93 than the other regions.