PT  - JOURNAL ARTICLE
AU  - Jin Choi
AU  - Gillian Booth
AU  - Hae Young Jung
AU  - Lauren Lapointe-Shaw
AU  - Terence Tang
AU  - Janice L. Kwan
AU  - Shail Rawal
AU  - Adina Weinerman
AU  - Amol Verma
AU  - Fahad Razak
TI  - Association of diabetes with frequency and cost of hospital admissions: a retrospective cohort study
AID  - 10.9778/cmajo.20190213
DP  - 2021 Apr 01
TA  - CMAJ Open
PG  - E406--E412
VI  - 9
IP  - 2
4099  - http://www.cmajopen.ca/content/9/2/E406.short
4100  - http://www.cmajopen.ca/content/9/2/E406.full
SO  - CMAJ2021 Apr 01; 9
AB  - Background: Acute inpatient hospital admissions account for more than half of all health care costs related to diabetes. We sought to identify the most common and costly conditions leading to hospital admission among patients with diabetes compared with patients without diabetes.Methods: We used data from the General Internal Medicine Inpatient Initiative (GEMINI) study, a retrospective cohort study, of all patients admitted to a general internal medicine service at 7 Toronto hospitals between 2010 and 2015. The Canadian Institute for Health Information (CIHI) Most Responsible Diagnosis code was used to identify the 10 most frequent reasons for admission in patients with diabetes. Cost of hospital admission was estimated using the CIHI Resource Intensity Weight. Comparisons were made between patients with or without diabetes using the Pearson χ2 test for frequency and distribution-free confidence intervals (CIs) for median cost.Results: Among the 150 499 hospital admissions in our study, 41 934 (27.8%) involved patients with diabetes. Compared with patients without diabetes, hospital admissions because of soft tissue and bone infections were most frequent (2.5% v. 1.9%; prevalence ratio [PR] 1.28, 95% CI 1.19–1.37) and costly (Can$8794 v. Can$5845; cost ratio [CR] 1.50, 95% CI 1.37–1.65) among patients with diabetes. This was followed by urinary tract infections (PR 1.16, 95% CI 1.11–1.22; CR 1.23, 95% CI 1.17–1.29), stroke (PR 1.13, 95% CI 1.07–1.19; CR 1.19, 95% CI 1.14–1.25) and electrolyte disorders (PR 1.11, 95% CI 1.03–1.20; CR 1.20, 95% CI 1.08–1.34).Interpretation: Soft tissue and bone infections, urinary tract infections, stroke and electrolyte disorders are associated with a greater frequency and cost of hospital admissions in patients with diabetes than in those without diabetes. Preventive strategies focused on reducing hospital admissions secondary to these disorders may be beneficial in patients with diabetes.