Study: Fayette above state norm in diabetes hospitalizations
With diabetes on the rise nationwide, the results of a recent Pennsylvania Health Care Cost Containment Council study that show a rise in diabetic-related hospitalizations came as no surprise to local doctors. According to the study, in 2001, Pennsylvania saw 298,941 hospitalizations in which diabetes was either the primary or secondary diagnosis. The figure represents a 17-percent increase since 1997 and a 4.4 percent rise since 2000. The study also found diabetes-related hospitalizations accounted for 16.5 percent of inpatient hospitalizations, about 2 percent more than in 1997.
The disease affects more than 500,000 Pennsylvanians and is the sixth-leading cause of death in the United States, according to the council.
Joe Martin, a spokesperson for the council, said that while the figures suggest a higher incidence of diabetes, the council couldn’t draw any conclusions from the study.
“We can speculate that it may be because more and more people are being diagnosed, but we don’t have figures,” Martin said. “Our goal is to track what is happening. It is not really within our ability to drill down to see why it is happening.”
Barbara Girod, vice president of clinical services at Greene County Memorial Hospital, said that hospitalizations will continue to rise, because the disease leads to a chronic state of illness.
“Your hospitalizations are longer, your medical care is more expensive and you need more care for more years,” she said.
According to an American Diabetes Association study done in 1997, diabetes costs $98 billion a year. Sue Shearer, diabetes educator for Fayette Home Care, sees hospitalizations as a direct result of less preventive and self-care.
“It is going to get really bad if lifestyles don’t change,” she said. “Diabetics wait until it gets really bad and their sugar goes up really high, and then something happens and someone has to hospitalize them.”
The council found that the 298,941 hospitalizations in 2001 accounted for 127,000 hospital days and resulted in more than $424 million in hospital charges. The study also found that while the rate of hospitalization for Type 1 diabetics has decreased slightly, the rate of hospitalizations for Type 2 diabetics has risen steadily since 1997. The 30- to 39-year-old age group experienced an increase of 26.1 percent, the largest of all groups. The study also found blacks to have the highest rate of hospitalization, as well as the highest rate of lower extremity amputations and end-stage renal disease.
Dr. Tim Jackson, an endocrinologist working in Fayette and Greene counties, said that socioeconomic factors play a part in the figures.
“African-Americans at a younger age are much more prone,” he said. “Socioeconomic status associated with education and health care result in less preventive care.”
According to the study, hospitalizations with a principal diagnosis of diabetes may be preventable because the care needed generally can be provided with outpatient care.
The study indicated that a possible conclusion for the rise is that patients allow themselves to go past the point where preventive and outpatient care is effective. The study speculated that the increase in hospitalizations may reflect the level of care the diabetic is providing himself.
The study also examined the percentage difference of the rate of hospitalizations in each county. While Greene County is 27.9 percent below the state rate, Fayette is one of the highest at 23.8 percent above the state average.
The report also found that the most common reasons for admittance were complications due to heart disease, which accounted for 158,587 hospitalizations, and complications of the respiratory system, which totaled 96,675 cases. Lower extremity amputations remained at a steady rate between 1997 and 2001 with 4.2 percent of diabetic hospitalizations for the procedure. Again, Greene County was below average at 17.8 percent, while Fayette was 18.7 percent above state norms.