Comorbidity of Type 2 Diabetes and Dementia among Hospitalized Patients in Los Angeles County: Hospitalization Outcomes and Costs, 2019–2021

IF 2.4 Q3 ENDOCRINOLOGY & METABOLISM Diabetology Pub Date : 2023-12-18 DOI:10.3390/diabetology4040052
D’Artagnan M. Robinson, Dalia Regos-Stewart, Mariana A. Reyes, Tony Kuo, N. Barragan
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Abstract

Hospitalizations for diabetes and dementia can impose a significant health and economic toll on older adults in the United States. This study sought to examine differences in hospitalization characteristics and outcomes associated with diabetes and dementia, separately and together, using 2019–2021 discharge record data from the California Department of Health Care Access and Information. The sampled group were residents of Los Angeles County who were aged 50+ at the time of the study. The multivariable linear regression analysis showed that compared to those with no diabetes or dementia, patients with diabetes alone exhibited the highest total charges, while those with comorbid diabetes and dementia exhibited lower charges (p < 0.05). The multinomial logistic regression found that patients with comorbid diabetes and dementia had the highest odds of having a length of stay of 7+ days (Adjusted Odds Ratio = 1.49; 95% Confidence Interval (CI) = 1.44–1.53). A matched case–control analysis revealed that comorbid diabetes and dementia were associated with significantly lower odds of hypertensive disease than diabetes alone (Matched Odds Ratio = 0.81; 95% CI = 0.67–0.97). Collectively, these results highlight the complex factors that may influence the variable hospitalization outcomes that are common occurrences in these three distinct disease profiles. Study findings suggest a need to consider these complexities when developing policies or strategies to improve hospitalization outcomes for these conditions.
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洛杉矶县住院患者中 2 型糖尿病和痴呆症的合并症:2019-2021年住院结果和成本
在美国,糖尿病和痴呆症的住院治疗会给老年人带来巨大的健康和经济损失。本研究试图利用加利福尼亚州医疗保健访问和信息部提供的 2019-2021 年出院记录数据,分别和共同研究与糖尿病和痴呆症相关的住院特征和结果的差异。抽样群体是洛杉矶县的居民,研究时年龄在 50 岁以上。多变量线性回归分析显示,与没有糖尿病或痴呆症的患者相比,单纯糖尿病患者的总费用最高,而合并糖尿病和痴呆症的患者费用较低(P < 0.05)。多项式逻辑回归发现,合并糖尿病和痴呆症的患者住院时间超过 7 天的几率最高(调整后比值比 = 1.49;95% 置信区间 (CI) = 1.44-1.53)。一项匹配病例对照分析显示,合并糖尿病和痴呆症的患者患高血压疾病的几率明显低于合并糖尿病的患者(匹配几率比 = 0.81;95% 置信区间 = 0.67-0.97)。总之,这些结果凸显了可能影响不同住院结果的复杂因素,而这些因素在这三种不同的疾病特征中是经常出现的。研究结果表明,在制定政策或策略以改善这些疾病的住院治疗结果时,需要考虑这些复杂因素。
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