OBJECTIVES: Diabetes mellitus (DM) is an ambulatory care sensitive condition, and good quality of diabetes outpatient care is important as DM causes a huge burden to both health care system and patients. Therefore, this study aimed to examine whether diabetes outpatient care for DM patients had improved over time, and to identify factors associated with risk of preventable hospitalization.

METHODS: Adults diagnosed with DM in 2004, 2009, and 2014 were recruited and their use of health services were retrieved from the National Health Insurance claims database. Indicators of preventable hospitalization – diabetes short-term complications admission, diabetes long-term complications admission, and uncontrolled diabetes admission - were adopted from the Preventable Quality Indicators developed by the Agency for Health Research and Quality. A sample of subjects randomly selected from patients of 2004, 2009, and 2014 was used for examining factors associated with indicators of preventable hospitalization. Logistic regression model was adopted for analysis.

RESULTS: Diabetes short-term complications admission rate, diabetes long-term complications admission rate, and uncontrolled diabetes admission rate were 0.51%, 1.98%, and 0.67% in 2005, 0.40%, 1.24%, and 0.45% in 2010, and 0.32%, 0.71%, and 0.32% in 2015, respectively. The majority of the sample was more than 55 years old, female, living in township or rural area, and having Charlson Comorbidity Index (CCI) score higher than zero. Older age, living in less-urbanized area, lower income level, higher CCI score, previous diabetes-related hospitalization, and poorer continuity of care were associated with higher risk of diabetes-related preventable hospitalization.

CONCLUSIONS: This study demonstrated that the trends of preventable hospitalization for short-term complications, long-term complications, and uncontrolled diabetes among DM patients were decreasing. However, patient characteristics and their care-seeking pattern were associated with risk of preventable hospitalization.