Purpose: In spite of temporal improvements in risk factor control, the status of diabetes care in the United States remains suboptimal. The contemporary burden imposed by this cardiovascular risk factor on the nation's emergency system is less well-understood. We sought to better characterize emergency department (ED) visits among adults ≥18 years that included a diagnosis of diabetes in the 2006-2010 Nationwide Emergency Department Sample.
Methods: We defined three diabetes-related outcomes any, uncontrolled/uncomplicated, and those with long-term complications using ICD-9 codes based on the Agency for Healthcare Research and Quality indicators for potentially preventable conditions. Appropriate sampling weights were applied to obtain national estimates and 95% confidence intervals.
Results: Over the 5-year period, the estimated total annual ED visits among adults in the US was 98.3 million and 11% of these visits included diabetes; this proportion tended to increase over time, varied across geographic regions, age groups, payer, and neighborhood income (Table). Less than 1% of total ED visits were related to uncontrolled/uncomplicated diabetes and <2% were related to long term complications; however, these proportions also differed by socio-demographic, insurance and hospital teaching status.
Conclusion: Between 2006 and 2010, an estimated 1,100 per 10,000 visits to the ED each year include a diabetes-related diagnosis among adults. For payer source, the proportion of ED visits with uncontrolled diabetes and long term complications was greatest among Medicare patients. Further research is warranted to determine the burden of diabetes in preventable ED visits.