Behavioral health conditions and potentially preventable diabetes-related hospitalizations in the United States: Findings from a national sample of commercial claims data

Stockbridge, Erica L.; Chhetri, Shlesma; Polcar, Leah E.; Loethen, Abiah D.; Carney, Caroline P.

doi:10.1371/journal.pone.0212955

Cited by 8 publications

(7 citation statements)

References 36 publications

(64 reference statements)

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“…However, for studies of people with underlying diabetes or cardiovascular disease presenting adjusted hazard ratios, there was little difference between diagnoses of bipolar disorder and schizophrenia. Of the seven studies included in our review which considered schizophrenia alongside other SMI diagnoses, two found patients with schizophrenia were more likely to be hospitalised than other SMI diagnoses [ 31 , 35 ], one found that those with schizophrenia were less likely to be hospitalised [ 36 ], and four found no significant difference [ 37 , 59 , 70 , 71 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of comorbid severe mental illness and common chronic physical health conditions on hospitalisation: A systematic review and meta-analysis

Launders¹,

Dotsikas²,

Marston³

et al. 2022

PLoS ONE

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Background People with severe mental illness (SMI) are at higher risk of physical health conditions compared to the general population, however, the impact of specific underlying health conditions on the use of secondary care by people with SMI is unknown. We investigated hospital use in people managed in the community with SMI and five common physical long-term conditions: cardiovascular diseases, COPD, cancers, diabetes and liver disease. Methods We performed a systematic review and meta-analysis (Prospero: CRD42020176251) using terms for SMI, physical health conditions and hospitalisation. We included observational studies in adults under the age of 75 with a diagnosis of SMI who were managed in the community and had one of the physical conditions of interest. The primary outcomes were hospital use for all causes, physical health causes and related to the physical condition under study. We performed random-effects meta-analyses, stratified by physical condition. Results We identified 5,129 studies, of which 50 were included: focusing on diabetes (n = 21), cardiovascular disease (n = 19), COPD (n = 4), cancer (n = 3), liver disease (n = 1), and multiple physical health conditions (n = 2). The pooled odds ratio (pOR) of any hospital use in patients with diabetes and SMI was 1.28 (95%CI:1.15–1.44) compared to patients with diabetes alone and pooled hazard ratio was 1.19 (95%CI:1.08–1.31). The risk of 30-day readmissions was raised in patients with SMI and diabetes (pOR: 1.18, 95%CI:1.08–1.29), SMI and cardiovascular disease (pOR: 1.27, 95%CI:1.06–1.53) and SMI and COPD (pOR:1.18, 95%CI: 1.14–1.22) compared to patients with those conditions but no SMI. Conclusion People with SMI and five physical conditions are at higher risk of hospitalisation compared to people with that physical condition alone. Further research is warranted into the combined effects of SMI and physical conditions on longer-term hospital use to better target interventions aimed at reducing inappropriate hospital use and improving disease management and outcomes.

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Section: Discussionmentioning

confidence: 99%

The impact of comorbid severe mental illness and common chronic physical health conditions on hospitalisation: A systematic review and meta-analysis

Launders¹,

Dotsikas²,

Marston³

et al. 2022

PLoS ONE

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show abstract

“…For instance, we could not control for weight measures such as body mass index (BMI) which is one of the significant predictors for diabetes-related risks 27 , 28 . In addition, healthy behavior such as dietary habits, smoking, drinking, and excise are important determinants particularly for diabetes 29 . We could not include information on the health settings such as a number of primary care providers.…”

Section: Discussionmentioning

confidence: 99%

Disparities in diabetes-related avoidable hospitalization among diabetes patients with disability using a nationwide cohort study

Youn

Choi

Jang

et al. 2022

Sci Rep

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Diabetes is an ambulatory care sensitive condition that quality of care can prevent complications development and hospitalization needs. However, diabetes patients with disability face greater challenges with receiving quality diabetes care than those without disabilities. This study examined diabetes-related avoidable hospitalizations (DRAH) focusing on the association with disability. We used nationally representative health insurance cohort data from 2002 to 2013. The study population is people who were newly diagnosed with type 2 diabetes. We measured the cumulated number of DRAH using the Prevention Quality Indicators (PQIs). The variables of interest were disability severity and type. We performed a recurrent events analysis using Cox proportional hazard regression model. Among 49,410 type 2 diabetes patients, 12,231 (24.8%) experienced DRAHs at least once during the follow-up period. Among the total population, 5924 (12.0%) diabetes patients were registered as disabled. The findings report that disability severity was significantly associated with higher risks for DRAH, where severely disabled diabetes patients showed the highest hazard ratio of 2.24 (95% CI 1.80–2.79). Among three DRAH indicators, severely disabled diabetes patients showed increased risks for long-term (AHR 2.21, 95% CI 1.89–2.60) and uncontrolled (AHR 2.28, 95% CI 1.80–2.88) DRAH. In addition, intellectual (AHR 5.52, 95% CI 3.78–8.05) and mental (AHR 3.97, 95% CI 2.29–6.89) disability showed higher risks than other types of disability. In conclusion, diabetes patients with disability are at higher risk for DRAH compared to those without disabilities, and those with intellectual and mental disabilities were more likely to experience DRAH compared to those with physical or other types of disability. These findings call for action to find the more appropriate interventions to improve targeted diabetes primary care for patients with disability. Further research is needed to better understand determinants of increasing risks of DRAH.

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“…We obtained data from the Clinformatics Data Mart database (Optum), which includes health insurance claims for individuals from all 50 US states receiving private health insurance from a large commercial insurer, with approximately 13 million covered lives annually . The individuals in the database represent about 19% of those with commercial health insurance, and their geographic distribution broadly matches the geographic distribution of the US population .…”

Section: Methodsmentioning

confidence: 99%

Assessment of Out-of-Network Billing for Privately Insured Patients Receiving Care in In-Network Hospitals

et al. 2019

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IMPORTANCE Although surprise medical bills are receiving considerable attention from lawmakers and the news media, to date there has been little systematic study of the incidence and financial consequences of out-of-network billing.OBJECTIVE To examine out-of-network billing among privately insured patients with an inpatient admission or emergency department (ED) visit at in-network hospitals. DESIGN, SETTING, AND PARTICIPANTSA retrospective analysis using data from the Clinformatics Data Mart database (Optum), which includes health insurance claims for individuals from all 50 US states receiving private health insurance from a large commercial insurer was conducted of all inpatient admissions (n = 5 457 981) and ED visits (n = 13 579 006) at in-network hospitals between January 1, 2010, and December 31, 2016. Data were collected and analyzed in March 2019.EXPOSURES Receipt of a bill for care from at least 1 out-of-network physician or medical transport service associated with patient admission or ED visit. MAIN OUTCOMES AND MEASURESThe incidence of out-of-network billing and the potential amount of patients' financial liability associated with out-of-network bills from the admission or visit.

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Behavioral health conditions and potentially preventable diabetes-related hospitalizations in the United States: Findings from a national sample of commercial claims data

Cited by 8 publications

References 36 publications

The impact of comorbid severe mental illness and common chronic physical health conditions on hospitalisation: A systematic review and meta-analysis

The impact of comorbid severe mental illness and common chronic physical health conditions on hospitalisation: A systematic review and meta-analysis

Disparities in diabetes-related avoidable hospitalization among diabetes patients with disability using a nationwide cohort study

Assessment of Out-of-Network Billing for Privately Insured Patients Receiving Care in In-Network Hospitals

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