BETHESDA, MD—Readmissions following hospitalization for diabetes often occur and are more common in minority patients, who experience greater rates of complications and lower quality healthcare compared to white patients.
A study in Military Medicine examined disparities in diabetes-related readmissions in the Military Health System, a universally insured population of 9.5 million beneficiaries. Patients receive care either from military (direct care) or civilian (purchased care) facilities.1
Uniformed Services University of the Health Sciences-led researchers identified a population of 7,605 adult diabetic patients admitted to the hospital in 2014. The study team used diagnostic codes to identify hospital readmissions, while logistic regression was used to analyze associations among race, beneficiary status, patient or sponsor’s rank, and readmissions at 30, 60, and 90 days.
Included in the analysis were 239 direct care patients and 545 purchased care patients. After adjusting for age and sex, researchers identified no significant difference in readmission rates for Black vs. white patients. On the other hand, a statistically significant increase in the likelihood for readmission of American Indians/Alaskan Native patients was documented, compared to white patients. Researchers said the trend persisted in direct care at 60 days (adjusted odds ratio [AOR] 11.51, 95% CI 1.11-119.41) and 90 days (AOR 18.42, 95% CI 1.78-190.73), and in purchased care at 90 days (AOR 4.54, 95% CI 1.31-15.74).
“Our findings suggest that universal access to healthcare alleviates disparities for Black patients, while Native America/Alaskan Native populations may still be at risk of disparities associated with readmissions among diabetic patients in both the closed direct care system and the civilian fee for service purchased care system,” the authors concluded.”
- Frankel D, Banaag A, Madsen C, Koehlmoos T. Examining Racial Disparities in Diabetes Readmissions in the United States Military Health System [published online ahead of print, 2020 Jul 7]. Mil Med. 2020;usaa153. doi:10.1093/milmed/usaa153