sábado, 8 de agosto de 2015

Length of Stay and Deaths in Diabetes-Related Preventable Hospitalizations Among Asian American, Pacific Islander, and White Older Adults on Medicare, Hawai‘i, December 2006–December 2010

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Length of Stay and Deaths in Diabetes-Related Preventable Hospitalizations Among Asian American, Pacific Islander, and White Older Adults on Medicare, Hawai‘i, December 2006–December 2010

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Length of Stay and Deaths in Diabetes-Related Preventable Hospitalizations Among Asian American, Pacific Islander, and White Older Adults on Medicare, Hawai‘i, December 2006–December 2010

Mary W. Guo, MPH; Hyeong Jun Ahn, PhD; Deborah T. Juarez, ScD; Jill Miyamura, PhD; Tetine L. Sentell, PhD

Suggested citation for this article: Guo MW, Ahn HJ, Juarez DT, Miyamura J, Sentell TL. Length of Stay and Deaths in Diabetes-Related Preventable Hospitalizations Among Asian American, Pacific Islander, and White Older Adults on Medicare, Hawai‘i, December 2006–December 2010. Prev Chronic Dis 2015;12:150092. DOI: http://dx.doi.org/10.5888/pcd12.150092.


The objective of this study was to compare in-hospital deaths and length of stays for diabetes-related preventable hospitalizations (D-RPHs) in Hawai‘i for Asian American, Pacific Islander, and white Medicare recipients aged 65 years or older.
We considered all hospitalizations of older (>65 years) Japanese, Chinese, Native Hawaiians, Filipinos, and whites living in Hawai‘i with Medicare as the primary insurer from December 2006 through December 2010 (n = 127,079). We used International Classification of Diseases – 9th Revision (ICD-9) codes to identify D-RPHs as defined by the Agency for Healthcare Research and Quality. Length of stays and deaths during hospitalization were compared for Asian American and Pacific Islander versus whites in multivariable regression models, adjusting for age, sex, location of residence (Oahu, y/n), and comorbidity.
Among the group studied, 1,700 hospitalizations of 1,424 patients were D-RPHs. Native Hawaiians were significantly more likely to die during a D-RPH (odds ratio [OR], 3.92; 95% confidence interval [CI], 1.42–10.87) than whites. Filipinos had a significantly shorter length of stay (relative risk [RR], 0.77; 95% CI, 0.62–0.95) for D-RPH than whites. Among Native Hawaiians with a D-RPH, 59% were in the youngest age group (65–75 y) whereas only 6.3% were in the oldest (≥85 y). By contrast, 23.2% of Japanese were in the youngest age group, and 32.2% were in the oldest.
This statewide study found significant differences in the clinical characteristics and outcomes of D-RPHs for Asian American and Pacific Islanders in Hawai‘i. Native Hawaiians were more likely to die during a D-RPH and were hospitalized at a younger age for a D-RPH than other studied racial/ethnic groups. Focused interventions targeting Native Hawaiians are needed to avoid these outcomes.


The research described was supported by the National Institute on Minority Health and Health Disparities (NIMHD) grant no. P20 MD000173 and was also supported in part by National Institutes of Health grant nos. U54MD007584 and G12MD007601, grant no. P20GM103466 from the Hawaii Statewide Research and Education Partnership, and grant no. RO1HS019990 from the Agency for Healthcare Research and Quality (AHRQ), US Department of Health and Human Services.

Author Information

Corresponding Author: Mary W. Guo, MPH, Office of Public Health Studies, University of Hawai‘i at Manoa, 1960 East-West Road, Biomed T102, Honolulu, HI 96822. Telephone: 808-956-9598. Email: maryguo@hawaii.edu.
Author Affiliations: Hyeong Jun Ahn, Biostatistics Core, John A. Burns School of Medicine, Honolulu, Hawai‘i; Deborah T. Juarez, Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo, Hilo, Hawai‘i; Jill Miyamura, Hawaii Health Information Corporation, Honolulu, Hawai‘i; Tetine L. Sentell, Office of Public Health Studies, University of Hawai‘i at Manoa, Honolulu, Hawai‘i.


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