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Complete Indicator Report of Ambulatory Care Sensitive Conditions: Diabetes Hospitalization Among Adults

Definition

Ambulatory care sensitive (ACS) conditions refer to those conditions for which hospitalizations could have been avoided, or conditions that could have been less serious, if they had been treated early and appropriately. Good outpatient management dramatically reduces the risk of hospitalization. For diabetes, an ACS condition refers to uncontrolled diabetes (type 1 and type 2), diabetes short-term and long-term complications, and amputations of lower extremities due to diabetes among adults aged 18 years and older.

As of November 2004, the IBIS diabetes information is based on four diabetes indicators (PQI 1, PQI 3, PQI 14, PQI 16) developed by the Agency for Healthcare Research and Quality Prevention Quality Indicators. National Healthcare Quality and Research provided the values for the national rate based on the National Inpatient Sample.

Numerator

Number of hospitalizations among persons aged 18 years and older with diabetes complications as the principal or secondary diagnosis code. Maternal, newborn, and transfer cases are excluded.

Denominator

Number of Utah residents aged 18 years and older.

Data Interpretation Issues

The four Agency for Healthcare Research and Quality Prevention Quality Indicators for diabetes use both principal and secondary ICD-9-CM diagnosis codes for hospitalization, include all adults (aged 18 years and older), but exclude cases that may result in over counting of diabetes cases. Specifically maternal, newborn, and transfer cases are excluded from uncontrolled diabetes, diabetes long-term complications, and diabetes short-term complications. Diabetes lower extremity amputation also excludes trauma cases. The Utah diabetes rate is risk-adjusted by age and gender so that comparison with the national rate is more meaningful. 95% confidence intervals are the criterion for statistical significance, that is, they indicate whether differences are real or due to "noise" in the data.

Why Is This Important?

Ambulatory care sensitive (ACS) conditions are conditions for which effective outpatient care can prevent hospitalizations. Diabetes is a disease for which regular physician visits can help to control blood sugar (glucose), fats (lipids), and blood pressure; screen for diabetes-related eye, foot, and kidney problems; and provide early treatment and patient education in self-management. Physician visits and early treatment can prevent otherwise avoidable hospitalizations and serious illness and injuries to patients. Diabetes complications include loss of consciousness, heart disease, stroke, circulation, kidney and nerve damage, impotence, blindness, amputation of extremities, and death.

Other Objectives

Similar to HP2020 Objective D-4: Reduce the rate of lower extremity amputations in persons with diagnosed diabetes.

How Are We Doing?

From 2000 through 2011, the annual risk-adjusted rate of Utah residents aged 18 years and older hospitalized for diabetes with short-term complications has generally increased. However, in years 2004 and 2009, short-term rate decreases were reported. Only the decrease in 2009 was considered statistically significant, in comparison to the preceding year. On the contrary, the risk-adjusted rate has generally decreased from 2000 to 2011 for diabetes with long-term complications, uncontrolled diabetes, and amputation of lower extremities.

How Do We Compare With U.S.?

Based on four adult diabetes indicators (short-term complications, long-term complications, lower extremity amputations, and uncontrolled), the annual risk-adjusted rate for Utah residents aged 18 years and older hospitalized for diabetes in 2000 through 2010 is significantly lower than the annual national rate most years (except 2002 and 2003 for short-term complications), based on the Agency for Healthcare Research and Quality/Healthcare Cost and Utilization Project.

What Is Being Done?

The Utah Diabetes Prevention and Control Program recognizes the importance of diabetes education and its role in preventing unnecessary hospitalizations. The Diabetes Prevention and Control Program currently certifies 13 state diabetes education programs throughout Utah.

Evidence-based Practices

Glycemic control (average preprandial glucose for diabetics: 90-130 mg/dl, average normal: <110 mg/dl) results in significant reductions in the incidence and rate of progression of retinopathy, albuminuria, and clinical neuropathy.

A1c tests show a diabetic's average glycemia over the preceding 2-3 months. A1c tests should be performed at least twice per year in patients who are meeting treatment goals and at least quarterly in patients who are not meeting glycemic goals.

Diet and exercise have been shown to help diabetics with glycemic control.

Diabetics have increased risk of cardiovascular disease. Lowering risks, such as hypertension (diastolic >=90 mmHG or systolic >=140 mmHG) are especially important for diabetics. (http://care.diabetesjournals.org/content/25/1/213.full)

Available Services

The Utah Diabetes Prevention and Control Program has developed a reference manual, Diabetes Resource Manual 2003 for Utah Diabetes Health Professionals, to assist health care providers in locating a variety of resources for their patients with diabetes throughout the state, including contact information for medical assistance programs such as Medicare, Medicaid, and Primary Care Network.

The health resource line, 888-222-2542, can provide individuals with information on locations for diabetes screening and classes. The resource line also has a list of doctors by area. The resource line is open Monday through Friday, 8 a.m. - 5 p.m.

Other Program Information

A1c levels less than 7% indicate good glucose control. The Diabetes Prevention and Control Program and the Office of Health Care Statistics collect HEDIS information on frequency of A1c exams for members of health plans throughout the state. The Diabetes Prevention and Control Program also conducts chart reviews to obtain A1c levels for a sample of health plan members.
See http://health.utah.gov/diabetes/



Related Indicators

Relevant Population Characteristics

The majority of hospitalizations for ACS conditions are for ketoacidosis, a life-threatening condition that develops when a person's cells cannot get enough glucose (sugar). Ketoacidosis generally occurs to people who develop diabetes at a younger age and have type 1, or insulin-dependent, diabetes. Hyperosmolar coma, a life-threatening condition that develops when a person has very high blood sugar, is uncommon and not often seen in people less than 65 with diabetes.

Related Relevant Population Characteristics Indicator Reports:


Health Care System Factors

Primary preventive care and regular office visits to a health care provider are essential for maintaining good blood sugar control. People who lack health insurance are less likely to have access to outpatient services that could decrease the risk of acute diabetes complications. Diabetes education can also help prevent complications through improved participation in self-management techniques.

Related Health Care System Factors Indicator Reports:


Risk Factors

Lack of access to preventive health care services, such as routine doctor visits and diabetes education, increases the risk of hospitalization for people with diabetes. Ketoacidosis is one of the most common reasons for hospitalization among the younger population with type 1 diabetes; however, it is also one of the most avoidable. Among older adults, the most common ACS condition is hyperosmolar coma. The risk of hyperosmolar coma increases with age.

Related Risk Factors Indicator Reports:


Health Status Outcomes

ACS conditions develop quickly and may become life-threatening in a short period of time. The most common type of diabetes-related ACS condition is ketoacidosis, a critical situation that occurs when the body's insulin supply is depleted. This condition is generally confined to type 1 patients (type 2 patients generally produce at least a small amount of insulin). If not treated promptly, ketoacidosis can lead to severe complications and death.

Related Health Status Outcomes Indicator Reports:




Graphical Data Views

Adult Hospitalizations due to Diabetes, Short-term Complications, Utah and U.S., 2000-2011

::chart - missing::

From 2000 through 2003 Utah's annual rate increased, then decreased in 2004, increased again through 2008, and decreased in 2009. The 2011 rate is significantly higher than the rate for 2009 and 2010, based on 95% confidence intervals. From 2000 through 2010 (the most recent available national data), the Utah annual rate was significantly lower than the national annual rate for all years except 2002 and 2003, which was obtained from the Agency for Healthcare Research and Quality/Healthcare Cost and Utilization Project (AHRQ/HCUP).

Geog: Utah vs. U.S. Year Risk-adjusted Discharges per 100,000 Adults Lower Limit Upper Limit
Utah 2000 36.9 28.8 45.0
Utah 2001 40.2 31.9 48.5
Utah 2002 45.2 36.5 53.9
Utah 2003 46.3 37.6 55.0
Utah 2004 36.8 33.9 39.8
Utah 2005 44.3 40.7 48.1
Utah 2006 44.3 40.6 48.0
Utah 2007 47.7 44.0 51.3
Utah 2008 47.5 43.9 51.2
Utah 2009 37.3 34.5 40.1
Utah 2010 40.0 36.6 43.5
Utah 2011 47.3 43.8 50.8
U.S. 2000 51.4 48.6 54.2
U.S. 2001 52.4 49.8 55.0
U.S. 2002 54.6 51.9 57.3
U.S. 2003 56.0 53.0 59.0
U.S. 2004 55.2 52.6 57.8
U.S. 2005 56.3 53.4 59.2
U.S. 2006 59.6 56.3 62.9
U.S. 2007 59.9 58.4 61.4
U.S. 2008 61.1 58.0 64.2
U.S. 2009 64.4 61.0 67.9
U.S. 2010 69.1 65.3 72.9
Record Count: 32

Data Notes

Numerator for Diabetes, Short-term Complications (PQI 1), includes principal diagnosis codes for diabetes, short-term complications (250.10-250.13, 250.20-250.23, 250.30-250.33). Risk-adjusted rates are adjusted for age and gender.

Data Sources

Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health. U.S. Census Bureau, 2010 Census. National Healthcare Quality and Research. Healthcare Cost and Utilization Project (HCUP), AHRQ.



Adult Hospitalizations due to Diabetes, Long-term Complications, Utah and U.S., 2000-2011

::chart - missing::

Utah's 2010 annual rate is significantly lower than the annual rate for 2000 through 2007, based on 95% confidence intervals. The annual rate increased in 2011, but did not significantly differ from 2010. From 2000 through 2010 (the most recent available national data), the Utah annual rate was statistically significantly lower than the national annual rate, which was obtained from the Agency for Healthcare Research and Quality/Healthcare Cost and Utilization Project.

Geog: Utah vs. U.S. Year Risk-Adjusted Discharges per 100,000 Lower Limit Upper Limit
Utah 2000 79.0 72.4 85.6
Utah 2001 78.2 71.7 84.7
Utah 2002 76.9 70.5 83.3
Utah 2003 77.2 70.9 83.6
Utah 2004 76.2 70.0 82.5
Utah 2005 71.0 64.8 77.1
Utah 2006 75.8 69.8 81.9
Utah 2007 73.4 67.5 79.4
Utah 2008 65.2 59.3 71.0
Utah 2009 60.5 54.7 66.2
Utah 2010 55.2 49.5 60.9
Utah 2011 59.3 53.7 65.0
U.S. 2000 117.8 112.2 123.4
U.S. 2001 117.1 112.1 122.1
U.S. 2002 121.2 115.9 126.5
U.S. 2003 120.7 114.4 127.0
U.S. 2004 124.9 118.8 131.0
U.S. 2005 122.4 116.0 128.8
U.S. 2006 126.9 119.8 134.0
U.S. 2007 123.3 117.2 129.4
U.S. 2008 121.0 114.4 127.6
U.S. 2009 114.5 107.9 121.0
U.S. 2010 116.2 110.2 122.3
Record Count: 32

Data Notes

For Diabetes, Long-term Complications (PQI 3), the numerator includes principal diagnosis codes 250.40-250.43, 250.50-250.53, 250.60-250.63, 250.70-250.73, 250.80-250.83, 250.90-250.93. Risk-adjusted rates are adjusted for age and gender.

Data Sources

Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health. U.S. Census Bureau, 2010 Census. National Healthcare Quality and Research. Healthcare Cost and Utilization Project (HCUP), AHRQ.



Adult Hospitalizations due to Diabetes, Uncontrolled, Utah and U.S., 2000-2011

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The annual Utah rate has decreased consecutively from 2000 through 2007. In 2008, the annual rate spiked, but has since been on the decline. From 2000 through 2010 (the most recent available national data), the Utah annual rate was statistically significantly lower than the national annual rate, which was obtained from the Agency for Healthcare Research and Quality/Healthcare Cost and Utilization Project.

Geog: Utah vs. U.S. Year Risk-adjusted Discharges per 100,000 Lower Limit Upper Limit
Utah 2000 8.6 6.0 11.2
Utah 2001 6.1 3.5 8.7
Utah 2002 6.8 4.3 9.4
Utah 2003 4.5 2.0 7.0
Utah 2004 4.3 1.8 6.7
Utah 2005 4.0 1.6 6.4
Utah 2006 3.8 1.4 6.2
Utah 2007 3.7 1.3 6.0
Utah 2008 4.3 1.9 6.6
Utah 2009 4.0 1.7 6.3
Utah 2010 3.9 1.7 6.2
Utah 2011 3.6 1.3 5.8
U.S. 2000 28.1 26.1 30.1
U.S. 2001 26.8 24.5 29.1
U.S. 2002 25.4 23.7 27.1
U.S. 2003 23.8 21.4 26.2
U.S. 2004 22.0 20.3 23.7
U.S. 2005 20.5 18.9 22.1
U.S. 2006 21.6 19.5 23.7
U.S. 2007 21.1 20.3 21.9
U.S. 2008 22.1 20.9 23.3
U.S. 2009 22.0 19.9 24.1
U.S. 2010 19.2 17.7 20.6
Record Count: 32

Data Notes

For Diabetes, Uncontrolled (PQI 14), the numerator includes principal diagnosis codes for diabetes uncontrolled, type 1 or type 2 (250.03, 250.02). Risk-adjusted rates are adjusted for age and gender.

Data Sources

Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health. U.S. Census Bureau, 2010 Census. National Healthcare Quality and Research. Healthcare Cost and Utilization Project (HCUP), AHRQ.



Adult Hospitalizations due to Diabetes, Lower Extremity Amputations, Utah and U.S., 2000-2011

::chart - missing::

The annual Utah rate has generally decreased from 2000 through 2010, with minor spikes occurring in 2001, 2006, and 2009. In 2011 the annual Utah rate decreased slightly, but the 2011 rate did not significantly differ from the 2010 rate. From 2000 through 2010 (the most recent available national data), the Utah annual rate was statistically significantly lower than the national rate, which was obtained from the Agency for Healthcare Research and Quality/Healthcare Cost and Utilization Project.

Geog: Utah vs. U.S. Year Risk-adjusted Discharges per 100,000 Lower Limit Upper Limit
Utah 2000 14.0 11.5 16.5
Utah 2001 14.1 11.6 16.5
Utah 2002 13.2 10.8 15.7
Utah 2003 13.0 10.6 15.4
Utah 2004 12.3 9.9 14.7
Utah 2005 10.6 8.3 12.9
Utah 2006 11.3 9.0 13.6
Utah 2007 10.9 8.7 13.2
Utah 2008 9.2 7.0 11.4
Utah 2009 9.6 7.4 11.7
Utah 2010 8.2 6.0 10.3
Utah 2011 7.9 5.8 10.0
U.S. 2000 40.4 38.3 42.9
U.S. 2001 38.7 36.7 40.7
U.S. 2002 39.7 37.4 42.0
U.S. 2003 38.4 36.1 40.7
U.S. 2004 38.3 36.2 40.4
U.S. 2005 34.9 32.7 37.1
U.S. 2006 35.4 33.3 37.5
U.S. 2007 33.6 32.7 34.6
U.S. 2008 33.3 32.4 34.3
U.S. 2009 32.1 30.2 33.9
U.S. 2010 33.0 31.0 34.9
Record Count: 32

Data Notes

For Diabetes, Lower Extremity Amputation (PQI 16), the numerator includes principal or secondary diagnosis codes for: (1) uncontrolled diabetes (250.00-250.03), (2) diabetes short-term complications (250.10-250.13, 250.20-250.23, 250.30-250.33), (3) diabetes long-term complications (250.40-250.43, 250.50-250.53, 250.60-250.63, 250.70-250.73, 250.80-250.83, 250.90-250.93), plus ICD-9-CM procedure codes for lower extremity amputation (84.10-84.19, toe amputation - except due to trauma - through abdominopelvic amputation). Risk-adjusted rates are adjusted for age and gender.

Data Sources

Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health. U.S. Census Bureau, 2010 Census. National Healthcare Quality and Research. Healthcare Cost and Utilization Project (HCUP), AHRQ.



Adult Hospitalization Rate for Diabetes, Short-term Complications by Patient County of Residence, Utah, 2011

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Among the 29 counties in 2011, Cache and Summit counties had a rate significantly lower than Utah overall, based on 95% confidence intervals, and Duchesne, Tooele, and Weber counties had a rate significantly higher than Utah overall.

County Risk-adjusted Rate per 100,000 Adults Lower Limit Upper Limit
Beaver 22.4 0.0 97.1
Box Elder 60.5 33.7 87.3
Cache 26.5 9.6 43.5
Carbon 64.2 24.2 104.2
Daggett 0.0 0.0 173.7
Davis 37.0 26.4 47.6
Duchesne 99.3 55.7 142.9
Emery 13.3 0.0 70.8
Garfield 27.0 0.0 109.1
Grand 0.0 0.0 59.1
Iron 71.5 45.4 97.7
Juab 0.0 0.0 59.9
Kane 38.8 0.0 108.3
Millard 11.9 0.0 66.2
Morgan 15.2 0.0 76.6
Piute 0.0 0.0 155.4
Rich 0.0 0.0 123.8
Salt Lake 45.2 39.6 50.8
San Juan 29.5 0.0 79.0
Sanpete 29.0 0.0 63.7
Sevier 20.7 0.0 62.2
Summit 0.0 0.0 29.7
Tooele 92.8 68.1 117.5
Uintah 41.9 9.6 74.2
Utah 44.7 36.7 52.8
Wasatch 5.8 0.0 43.9
Washington 48.6 33.0 64.1
Wayne 0.0 0.0 112.7
Weber 65.1 53.1 77.2
State 47.3 43.8 50.8
Record Count: 30

Data Notes

Numerator for Diabetes, Short-term Complications (PQI 1), includes principal diagnosis codes for diabetes, short-term complications (250.10-250.13, 250.20-250.23, 250.30-250.33). Risk-adjusted rates are adjusted for age and gender.

Data Sources

Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health. Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau. National Healthcare Quality and Research. Healthcare Cost and Utilization Project (HCUP), AHRQ.



Adult Hospitalization Rate for Diabetes, Long-term Complications by Patient County of Residence, Utah 2011

::chart - missing::

Among the 29 counties in 2011, no county had a rate significantly lower than the Utah overall rate, and no county had a significantly higher rate than the Utah overall rate.

County Risk-adjusted Rate per 100,000 Adults Lower Limit Upper Limit
Beaver 21.6 0.0 126.9
Box Elder 40.6 0.5 80.6
Cache 29.8 0.0 59.8
Carbon 119.0 62.3 175.7
Daggett 0.0 0.0 218.4
Davis 41.9 24.7 59.0
Duchesne 43.0 0.0 109.5
Emery 50.8 0.0 131.6
Garfield 67.2 0.0 174.4
Grand 12.9 0.0 94.4
Iron 14.5 0.0 57.7
Juab 31.3 0.0 121.1
Kane 14.9 0.0 102.3
Millard 65.1 0.0 139.8
Morgan 15.9 0.0 106.3
Piute 0.0 0.0 186.6
Rich 55.9 0.0 225.4
Salt Lake 61.0 51.9 70.2
San Juan 52.3 0.0 125.7
Sanpete 16.9 0.0 70.8
Sevier 85.5 27.4 143.6
Summit 15.9 0.0 61.1
Tooele 58.3 18.6 98.1
Uintah 82.9 31.3 134.6
Utah 56.7 42.0 71.4
Wasatch 20.4 0.0 79.6
Washington 59.5 38.0 81.0
Wayne 0.0 0.0 150.6
Weber 78.4 59.6 97.2
State 59.3 53.7 65.0
Record Count: 30

Data Notes

For Diabetes, Long-term Complications (PQI 3), the numerator includes principal diagnosis codes 250.40-250.43, 250.50-250.53, 250.60-250.63, 250.70-250.73, 250.80-250.83, 250.90-250.93. Risk-adjusted rates are adjusted for age and gender.

Data Sources

Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health. Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau. National Healthcare Quality and Research. Healthcare Cost and Utilization Project (HCUP), AHRQ.



Adult Hospitalization Rate for Diabetes, Uncontrolled by Patient County of Residence, Utah, 2011

::chart - missing::

For Diabetes, Uncontrolled (PQI 14), of the 29 counties in 2011, no county had a significantly lower rate than the Utah overall rate, and Carbon County had a significantly higher rate than the Utah overall rate.

County Risk-adjusted Rate per 100,000 Adults Lower Limit Upper Limit
Beaver 0.0 0.0 43.6
Box Elder 3.1 0.0 19.4
Cache 0.0 0.0 11.8
Carbon 32.0 8.5 55.5
Daggett 0.0 0.0 93.8
Davis 1.6 0.0 8.4
Duchesne 0.0 0.0 27.1
Emery 0.0 0.0 33.5
Garfield 0.0 0.0 45.3
Grand 0.0 0.0 33.7
Iron 7.0 0.0 24.4
Juab 15.5 0.0 52.0
Kane 0.0 0.0 37.2
Millard 11.3 0.0 42.4
Morgan 0.0 0.0 36.8
Piute 0.0 0.0 80.3
Rich 0.0 0.0 71.1
Salt Lake 2.3 0.0 5.9
San Juan 0.0 0.0 29.9
Sanpete 0.0 0.0 22.0
Sevier 20.4 0.0 44.6
Summit 0.0 0.0 18.0
Tooele 8.6 0.0 24.3
Uintah 0.0 0.0 20.7
Utah 3.8 0.0 9.5
Wasatch 0.0 0.0 23.7
Washington 4.7 0.0 13.8
Wayne 0.0 0.0 63.1
Weber 7.3 0.0 14.9
State 3.6 1.3 5.8
U.S. 19.2 17.7 20.6
Record Count: 31

Data Notes

For Diabetes, Uncontrolled (PQI 14), the numerator includes principal diagnosis codes for diabetes uncontrolled, type 1 or type 2 (250.03, 250.02). Risk-adjusted rates are adjusted for age and gender.

Data Sources

Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health. Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau. National Healthcare Quality and Research. Healthcare Cost and Utilization Project (HCUP), AHRQ.



Adult Hospitalization Rate for Diabetes, Lower Extremity Amputation by Patient County of Residence, Utah, 2011

::chart - missing::

For Diabetes, Lower Extremity Amputation (PQI 16) in 2011, among the 29 counties, no county rate was significantly lower than the rate for Utah overall. Carbon county had an annual rate that was significantly higher than the rate for Utah overall, based on 95% confidence intervals.

County Risk-adjusted Rate per 100,000 Adults Lower Limit Upper Limit
Beaver 0.0 0.0 38.2
Box Elder 6.3 0.0 21.0
Cache 5.6 0.0 17.0
Carbon 36.5 16.0 57.1
Daggett 83.0 7.1 158.9
Davis 4.9 0.0 11.3
Duchesne 0.0 0.0 24.4
Emery 0.0 0.0 29.1
Garfield 0.0 0.0 38.0
Grand 0.0 0.0 29.5
Iron 14.7 0.0 30.7
Juab 0.0 0.0 33.0
Kane 0.0 0.0 30.8
Millard 0.0 0.0 26.8
Morgan 0.0 0.0 33.1
Piute 0.0 0.0 65.4
Rich 0.0 0.0 60.4
Salt Lake 7.2 3.7 10.6
San Juan 20.8 0.0 47.6
Sanpete 0.0 0.0 19.6
Sevier 6.3 0.0 27.3
Summit 12.2 0.0 29.0
Tooele 9.8 0.0 24.9
Uintah 16.1 0.0 35.4
Utah 5.1 0.0 10.8
Wasatch 0.0 0.0 22.1
Washington 6.9 0.0 14.6
Wayne 0.0 0.0 53.9
Weber 9.2 2.2 16.2
State 7.9 5.8 10.0
Record Count: 30

Data Notes

For Diabetes, Lower Extremity Amputation (PQI 16), the numerator includes principal or secondary diagnosis codes for: (1) uncontrolled diabetes (250.00-250.03), (2) diabetes short-term complications (250.10-250.13, 250.20-250.23, 250.30-250.33), (3) diabetes long-term complications (250.40-250.43, 250.50-250.53, 250.60-250.63, 250.70-250.73, 250.80-250.83, 250.90-250.93), plus ICD-9-CM procedure codes for lower extremity amputation (84.10-84.19, toe amputation - except due to trauma - through abdominopelvic amputation). Risk-adjusted rates are adjusted for age and gender.

Data Sources

Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health. Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau. National Healthcare Quality and Research. Healthcare Cost and Utilization Project (HCUP), AHRQ.


References and Community Resources

National Diabetes Education Program
Internet http://yourdiabetesinfo.org

American Diabetes Association
800-342-2383 or 800-DIABETES for diabetes information
Internet http://www.diabetes.org, http://care.diabetesjournals.org/content/25/1/213.full

A list of state-certified and ADA-recognized diabetes education programs can be found on the Utah Diabetes Control Program web site.
Internet http://health.utah.gov/diabetes

For more information on the ACS conditions, see AHRQ Quality Indicators, Guide to Prevention Quality Indicators: Hospital Admission for Ambulatory Care Sensitive Conditions, Department of Health and Human Services, Agency for Healthcare Research and Quality, October 2001 (AHRQ Pub. No. 02-R0203)

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 04/01/2013, Published on 04/09/2013
Office of Health Care Statistics, Center for Health Data, Utah Department of Health, Salt Lake City, UT 84114-4004, Telephone: 801-538-7048, Fax: 801-538-9916, Website: www.health.utah.gov/hda, Email: HEALTHCARESTAT@utah.gov
The information provided above is from the Utah Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.utah.gov). The information published on this website may be reproduced without permission. Please use the following citation: "Retrieved Tue, 21 May 2013 7:56:06 from Utah Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.utah.gov".

Content updated: Tue, 21 May 2013 7:56:06