Important Facts for Diabetes as Primary Diagnosis for Hospitalization

Definition

Inpatient hospital discharges with an ICD-10 code as the primary diagnosis that ranges between E10-E14. ICD-10-CM/PCS code sets took effect on October 1, 2015. Prior to October 1, 2015 the follow ICD-9 codes were used as the primary diagnosis 250.0-250.9.

Numerator

Number of hospital discharges listing diabetes as the primary diagnosis.

Denominator

All Utah residents.

Data Interpretation Issues

Hospital records may contain up to 10 diagnosis codes. The first listed diagnosis is generally considered the primary reason for the hospitalization.

Why Is This Important?

Diabetes is an enormous burden on the healthcare system. The direct and indirect costs of diabetes nationally are estimated to be at least $413 billion per year. (Centers for Disease Control and Prevention: Diabetes Fast Facts, 2023 [https://www.cdc.gov/diabetes/basics/quick-facts.html]).

How Are We Doing?

The crude rate of hospital discharges listing diabetes as the primary diagnosis per 10,000 Utah population has been fairly consistent during the past 5 years, between 9 and 12 discharges per 10,000 population. In 2022 the crude rate was 10.9 (10.5-11.2) diabetes discharges per 10,000 population.

How Do We Compare With the U.S.?

Rates of hospitalization for discharges listing diabetes as the primary diagnosis for the U.S. are substantially higher than those for Utah. The overall rate of hospital discharges with diabetes as the primary diagnosis was 33.5 per 10,000 population for the U.S in 2020. ([https://www.cdc.gov/diabetes/data/statistics-report/index.html]).

What Is Being Done?

The Healthy Environments Active Living (HEAL) program encourages people with diabetes to enroll in a [https://heal.utah.gov/dsmes/ diabetes self-management education class]. These classes have been shown to help individuals develop the skills they need to manage their diabetes and are usually taught by dietitians, nurses, or pharmacists, who may also hold the status of Certified Diabetes Educator (CDE). CDEs have considerable expertise in diabetes management and understand what the individual with diabetes is going through. The Utah Healthy Aging Program supports Chronic Disease Self-Management Programs and Diabetes Self-Management Programs throughout the state, this program is also called the Living Well with Chronic Conditions Program. This six-week program is available throughout the state at no cost and taught by community members. Information is available from Nichole Shepard, 385-315-2000, nshepard@utah.gov. More information is available on the [https://healthyaging.utah.gov/livingwell/ Healthy Aging Program website]. The HEAL program is working statewide to increase the number of locations that offer Diabetes Self-Management Education (DSME) and also promote DSME to eligible participants. The National Diabetes Prevention Program (National DPP) is also an evidence-based program to prevent type 2 diabetes. The HEAL program works with statewide partners to promote the National DPP to eligible Utahns and also is working to expand National DPP sites across the state.

Evidence-based Practices

Diabetes Self-Management Classes have been shown to improve blood sugar control among participants. In Utah, programs are available that are recognized by the American Diabetes Association or certified by the American Association of Diabetes Educators. Information on classes in Utah is available on the [https://heal.utah.gov/dsmes/ HEAL website].

Health Program Information

The Utah Department of Health and Human Services Resource Line can provide information about enrolling in diabetes self-management classes. Call 1-888-222-2542 for more information. The Utah Department of Health and Human Services, Healthy Environments Active Living program plays a key role in improving the health of residents in the state of Utah. The program was formed in July 2013 (as EPICC), through a new funding opportunity from the Centers of Disease Control and Prevention (CDC) that allowed for the merging of three previously existing programs: the Heart Disease and Stroke Prevention Program, the Diabetes Prevention and Control Program, and the Physical Activity, Nutrition and Obesity Program, as well as the addition of a school health program. The Healthy Environments Active Living Program (HEAL) was recently restructured as part of this strategic planning process and the new program model focuses on working together with staff and partners to address the social determinants of health while advancing health equity and increasing policy, systems and environment changes. HEAL champions public health initiatives and addresses the challenges of making health awareness and access truly universal and equitable in eight key areas: nutrition, heart health, diabetes, physical activity, schools, child care, community health workers, and worksites. Visit [https://heal.utah.gov/ HEAL's website] for more information.