The Relationship between Diabetes Care Quality and Diabetes-Related Hospitalizations and the Modifying Role of Comorbidity

Petrosyan, Yelena; Bai, Yu; Pefoyo, Anna J. Koné; Gruneir, Andrea; Thavorn, Kednapa; Maxwell, Colleen J.; Bronskill, Susan E.; Wodchis, Walter P.

doi:10.1016/j.jcjd.2016.06.006

Cited by 54 publications

(42 citation statements)

References 29 publications

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“…For example, Woodard et al confirmed higher achievement of diabetes care goals for glycemic and lipid control in patients with discordant comorbidity only compared with those with diabetes only . Petrosyan et al also showed that either type of comorbidity in patients was associated with meeting diabetes goals of HbA1c testing or low‐density lipoprotein cholesterol testing . These findings could be explained by the frequent interaction of patients with healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

“…15 Petrosyan et al also showed that either type of comorbidity in patients was associated with meeting diabetes goals of HbA1c testing or lowdensity lipoprotein cholesterol testing. 16 These findings could be explained by the frequent interaction of patients with healthcare providers. In fact, in the present study, patients with comorbidity had almost double the number of physician office visits than those with diabetes only.…”

Section: Discussionmentioning

confidence: 99%

“…15 However, Pentakota et al reported poor quality of care among patients having discordant comorbidity compared with patients without comorbidity. 11 Other studies suggest that patients with diabetes and discordant comorbidity also have an increased risk for additional visit to general practitioners, 16 higher utilization of healthcare services, increased treatment costs, 17 and lower health-related quality of life (HRQoL) 18 than patients with only concordant conditions. Understanding different types of comorbidity and their effects on the quality of care, as well as HROoL and economic outcomes is important.…”

Section: Introductionmentioning

confidence: 99%

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Association between different types of comorbidity and disease burden in patients with diabetes

Dang

2018

Journal of Diabetes

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between different types of comorbidity and disease burden in patients with diabetes

Dang

2018

Journal of Diabetes

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“…(Appendix 1). [34][35][36][37][38][39][40] We determined the prevalence of any cancer using the OCR. Liver failure and liver transplant were ascertained if one ICD9 or ICD10 code was billed in OHIP or DAD in the previous 10 years.…”

Section: Discussionmentioning

confidence: 99%

HCV-Infected Individuals have Higher Prevalence of Comorbidity and Multimorbidity: A retrospective cohort study

Cooper

Galanakis

Donelle

et al. 2019

Preprint

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Background Almost 1% of Canadians are hepatitis C (HCV)-infected. The liver-specific complications of HCV are established but the extra-hepatic comorbidity, multimorbidity, and its relationship with HCV treatment, is less well known. We describe the morbidity burden for people with HCV and the relationship between multimorbidity and HCV treatment in the pre- and post-direct acting antiviral (DAA) era. Methods We linked adults with HCV at The Ottawa Hospital Viral Hepatitis Program as of April 1, 2017 to provincial health administrative data and matched on age and sex to 5 Ottawa-area residents for comparison. We used validated algorithms to identify the prevalence of mental and physical health comorbidities, as well as multimorbidity (2+ comorbidities). We calculated direct age- and sex-standardized rates of comorbidity and comparisons were made by interferon-based and DAA HCV treatments. Results The mean age of the study population was 54.5 years (SD 11.4), 65% were male. Among those with HCV, 4% were HIV co-infected, 26% had liver cirrhosis, 47% received DAA treatment, and 57% were cured of HCV. After accounting for age and sex differences, the HCV group had greater multimorbidity (prevalence ratio (PR) 1.38, 95% confidence interval (CI) 1.20 to 1.58) and physical-mental health multimorbidity (PR 2.71, 95% CI 2.29 – 3.20) compared to the general population. Specifically, prevalence ratios for people with HCV were significantly higher for diabetes, renal failure, cancer, asthma, chronic obstructive pulmonary disease, substance use disorder, mood and anxiety disorders and liver failure. HCV treatment and cure were not associated with multimorbidity, but treatment prevalence was significantly lower among middle-aged individuals with substance use disorders despite no differences in prevalence of cure among those treated. Conclusion People with HCV have a higher prevalence of comorbidity and multimorbidity compared to the general population. While HCV treatment was not associated with multimorbidity, people with substance use disorder were less likely to be treated. Our results point to the need for integrated, comprehensive models of care delivery for people with HCV.

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“…We also flagged any hospitalization where the most responsible diagnosis was for any of the following chronic physical and mental health ACSCs commonly comorbid with diabetes: obesity (ICD-10-CA codes E66.x), hyperlipidemia (E78.x), hypertension (I10.x-I15.x), ischemic heart disease (I20.x-I25.x), cardiomyopathy (I42.x-I43.x), cardiac arrhythmia (I47.x-I49.x), congestive heart failure (I50.x), stroke (I60.x-I64.x), coronary atherosclerosis (I70.x), thromboembolism (I80.x-I82.x), chronic obstructive pulmonary disease (J41.x-J45.x), chronic kidney disease (N18.x), and polycystic ovarian syndrome (E28.2) as well as mood and anxiety disorders (F30.x-F48.x). While different studies and healthcare organizations use different categorizations of what is considered an ACSC, these conditions have been considered to reflect common coexisting physical and mental health disorders among persons with diabetes relevant for investigations of multimorbidity, care interventions, and preventable hospitalizations [7,8,31].…”

Section: Discharge Abstract Database (Dad)mentioning

confidence: 99%

Population-based study of the association between food insecurity and preventable hospitalization among persons with diabetes using linked survey and administrative data

Gupta

Sheng

2019

IJPDS

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BackgroundStudies have found food insecurity to be more prevalent among persons with diabetes mellitus. Other research using areal-based measures of socioeconomic status have pointed to a social gradient in diabetes hospitalizations, but without accounting for individuals' health status. Linking person-level data from health surveys to population-based hospital records enables profiling of the role of food insecurity with hospital morbidity, focusing on the high-risk diabetic population.

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The Relationship between Diabetes Care Quality and Diabetes-Related Hospitalizations and the Modifying Role of Comorbidity

Abstract: Meeting diabetes testing goals has the potential to reduce hospitalizations for diabetes-related complications; however, this depends on types of coexisting chronic conditions and diabetes-related complications in patients with diabetes.

Cited by 54 publications

References 29 publications

Association between different types of comorbidity and disease burden in patients with diabetes

Association between different types of comorbidity and disease burden in patients with diabetes

HCV-Infected Individuals have Higher Prevalence of Comorbidity and Multimorbidity: A retrospective cohort study

Population-based study of the association between food insecurity and preventable hospitalization among persons with diabetes using linked survey and administrative data

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