OBJECTIVES: The Healthcare Cost and Utilization Project (HCUP) estimates that between 2009 and 2014 the number of type 2 diabetes patient visits increased by 0.47 million and 3.2 million in the inpatient and emergency department (ED) settings, respectively. The objective of this study was to evaluate the trends in type 2 diabetes patient hospital visits and outcomes over the last 8 years.

METHODS: A US electronic health record dataset (Cerner Health Facts®) of over 450 million patient visits was examined. Visits involving adult patients (≥18 years) with ICD-9/10 codes for type 2 diabetes admitted to inpatient or ED care between January 2009 and December 2016 were retrospectively analyzed. Visit-based data for length of stay, mortality rates, hospital charges and 30-day readmission rates were examined.

RESULTS: The percentage of all hospital visits associated with type 2 diabetes significantly increased from 2009 to 2016 (7% to 19% for the inpatient; 2% to 6% for the ED; p<0.001). The majority of both inpatient and ED visits comprised patients who were male, ≥50 years of age, African American, and using Medicare. The median length of stay significantly decreased from 81 hours in 2009 to 75 hours in 2016 (p<0.001), while it remained the same for the ED (3.8 hours). The median visit charges significantly increased in both care settings ($21,141 to $24,695 for the inpatient; $2,573 to $3,827 for the ED; p<0.001). Patient mortality rates remained steady, ranging between 3 to 4% for the inpatient and 0.5 to 0.8% for the ED. Notably, all-cause, 30-day readmission rates for diabetic inpatient visits significantly increased from 11% to 14% (p<0.001).

CONCLUSIONS: This study highlights potentially important clinical and economic trends in the type 2 diabetes population between 2009 and 2016 across the inpatient and ED care settings.