1. Temporal patterns of hospitalizations for diabetic ketoacidosis in children and adolescents
- Author
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Arpita Vyas and Lavi Oud
- Subjects
Male ,Databases, Factual ,Economics ,Epidemiology ,Ethnic group ,Social Sciences ,Adolescents ,Pediatrics ,Geographical locations ,Families ,Endocrinology ,Medical Conditions ,Medicine and Health Sciences ,Ethnicities ,Child ,Children ,Hispanic People ,Multidisciplinary ,Hospital Charges ,Texas ,Hospitals ,Hospitalization ,Child, Preschool ,Cohort ,Medicine ,Female ,Research Article ,medicine.medical_specialty ,Adolescent ,Diabetic ketoacidosis ,Endocrine Disorders ,Science ,Diabetic Ketoacidosis ,Sex Factors ,Health Economics ,Diabetes Mellitus ,medicine ,Humans ,Retrospective Studies ,Hospitalizations ,business.industry ,Infant ,Retrospective cohort study ,medicine.disease ,United States ,Underinsured ,Health Care ,Health Care Facilities ,Age Groups ,Fiscal impact ,Metabolic Disorders ,North America ,Emergency medicine ,Population Groupings ,People and places ,business ,Medicaid ,Health Insurance ,Pediatric population - Abstract
Objectives To examine the temporal patterns of hospitalizations with diabetic ketoacidosis (DKA) in the pediatric population and their associated fiscal impact. Methods The Texas Inpatient Public Use Data File was used to identify hospitalizations of state residents aged 1month-19 years with a primary diagnosis of DKA during 2005–2014. Temporal changes of population-adjusted hospitalization rates and hospitalization volumes were examined for the whole cohort and on stratified analyses of sociodemographic attributes. Changes in the aggregate and per-hospitalization charges were assessed overall and on stratified analyses. Results There were 24,072 DKA hospitalizations during the study period. The population-adjusted hospitalization rate for the whole cohort increased from 31.3 to 35.9 per 100,000 between 2005–2006 and 2013–2014. Hospitalization volume increased by 30.2% over the same period, driven mainly by males, ethnic minorities, those with Medicaid insurance and uninsured patients. The aggregate hospital charges increased from approximately $69 million to $130 million between 2005–2006 and 2013–2014, with 66% of the rise being due to increased per-hospitalization charges. Conclusions There was progressive rise in pediatric DKA hospitalizations over the last decade, with concurrent near-doubling of the associated fiscal footprint. Marked disparities were noted in the increasing hospitalization burden of DKA, born predominantly by racial and ethnic minorities, as well as by the underinsured and the uninsured. Further studies are needed to identify scalable preventive measures to achieve an equitable reduction of pediatric DKA events.
- Published
- 2021
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