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Complete Health Indicator Report of 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 health care system. The direct and indirect costs of diabetes nationally are estimated to be at least $327 billion per year. (Centers for Disease Control and Prevention: Diabetes Fast Facts, 2020 [https://www.cdc.gov/diabetes/basics/quick-facts.html]).

Healthy People Objective D-5:

Improve glycemic control among persons with diabetes
U.S. Target: Not applicable, see subobjectives in this category

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 11 discharges per 10,000 population. In 2020 the crude rate was 10.29 (9.95-10.65) diabetes discharges per 10,000 population, or 3,345 discharges.

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 20.8 per 10,000 population for the U.S. Source: U.S. data from 2007 National Hospital Discharge Survey (http://www.cdc.gov/nchs/data/nhsr/nhsr029.pdf).

What Is Being Done?

The Healthy Environments Active Living (HEAL) program encourages people with diabetes to enroll in a 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 Arthritis 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, 801-538-6259, nshepard@utah.gov. More information is available on the [http://livingwell.utah.gov/ Living Well Utah website]. The HEAL program is working statewide to increase the number of locations that offer DSME and also promote DSME to eligible participants. The 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 [http://livingwell.utah.gov/ Living Well Utah website].

Available Services

The American Diabetes Association (ADA) is an excellent resource for all types of information on diabetes. Call 1-800-DIABETES or visit the [http://www.diabetes.org website]. [https://www.niddk.nih.gov/health-information/communication-programs/ndep The National Diabetes Education Program] has resources for diabetes management for professionals, businesses, and patients. Most materials are available upon request at no charge. [https://www.cdc.gov/diabetes/prevention/index.html The National Diabetes Prevention Program] has resources for diabetes prevention for employers, insurers, health care professionals, program providers, and individuals. [https://health.utah.gov/ The Utah Department of Health] has a Health Resource hotline: 1-888-222-2542. Please call this number for information about self-management programs in Utah. The Healthy Living through Environment, Policy and Improved Clinical Care (EPICC) website provides information of [http://www.choosehealth.utah.gov/your-health/lifestyle-change/dsme.php diabetes self-management classes]. [http://www.diabeteseducator.org Association of Diabetes Educators][[br]] 800-338-3633[[br]] Local Chapter Facebook Page: [https://www.facebook.com/aadeutah/] [http://www.heart.org American Heart Association][[br]] 1937 S. 300 W. #120[[br]] Salt Lake City, UT 84115[[br]] (801) 484-3838 or[[br]] 1-800-242-8721

Health Program Information

The Utah Department of Health Resource Line can provide information about enrolling in diabetes self-management classes. Call 1-888-222-2542 for more information. Originally known as EPICC, (The Healthy Living through Environment, Policy, and Improved Clinical Care Program), the Healthy Environments Active Living (HEAL) Program is a program within the Utah Department of Health Bureau of Health Promotion. HEAL focuses on enabling education and engaged change for public health by engaging its three main audiences: individuals, partners, and decision makers. 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. The HEAL Program aims to reduce the incidence of diabetes, heart disease, and stroke by targeting risk factors including reducing obesity, increasing physical activity and nutritious food consumption, and improving diabetes and hypertension control. [[br]] The primary program strategies include: *Increasing healthy nutrition and physical activity environments in K-12 schools *Increasing healthy nutrition and physical activity environments in early care and education (childcare/preschool) *Increasing healthy nutrition and physical activity environments in worksites *Improving awareness of prediabetes and hypertension for Utahns *Improving the quality of medical care for people with diabetes and hypertension *Improving the linkages between health care providers and supporting community programs for Utahns with diabetes and hypertension *Improving access and availability to community health programs for Utahns with diabetes, hypertension, and obesity. *Improving care and management of students with chronic conditions in Utah schools


Related Indicators

Relevant Population Characteristics

Individuals with diabetes have higher rates of hospitalization than those without diabetes across every age group. The most common reason for hospitalization among youth with diabetes is ketoacidosis. Older individuals are most likely to be hospitalized for diabetes-related cardiovascular problems.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

In 2020 there were 3.345 discharges from Utah hospitals listing diabetes as the primary diagnosis. The average charge for a hospital discharge with diabetes as the primary diagnosis was $18,504 (with a median charge of $11,476). People with diabetes are hospitalized for both acute and chronic complications. Many hospitalizations due to diabetes could be prevented if sufficient outpatient and self-management care is available, accessible, and obtained.

Related Health Care System Factors Indicators:


Risk Factors

Many hospitalizations related to diabetes may be avoided with proper self-management and regular, routine physician visits. One of the most preventable causes of hospitalization is ketoacidosis. It is, nevertheless, the leading cause of hospitalization among youth with diabetes.

Related Risk Factors Indicators:


Health Status Outcomes

Individuals with diabetes should make special efforts to seek good health. Behavioral measures, such as having an adequate amount of physical activity, eating a nutritious diet, and maintaining a healthy weight can substantially lower the risk of hospitalization.

Related Health Status Outcomes Indicators:




Graphical Data Views

Hospitalizations With Diabetes as the Primary Diagnosis (Crude Rates) by Utah Local Health District, 2019-2020

::chart - missing::
confidence limits

The following local health districts had statistically significantly higher crude rates of hospitalization due to diabetes compared to the state: Central (13.2), San Juan (17.3), Southeast (11.0), Summit (14.6), Tooele (16.5), and Wasatch (12.5). The following local health districts had statistically significantly lower crude rates of hospitalization due to diabetes compared to the state: Davis (8.9), Southwest (5.6), TriCounty (8.6), Weber-Morgan (5.6).
Local Health DistrictCrude Rate per 10,000 PopulationLower LimitUpper Limit
Record Count: 14
Bear River9.58.610.6
Central13.211.515.1
Davis County8.98.29.6
Salt Lake County11.310.811.7
San Juan17.314.520.4
Southeast11.911.012.9
Southwest5.64.17.4
Summit14.612.716.7
Tooele16.514.219.0
TriCounty8.68.19.1
Utah County6.54.78.7
Wasatch12.511.613.5
Weber-Morgan5.63.28.9
State of Utah10.710.410.9

Data Notes

ICD-10 codes E10-E14. Prior to 2015, ICD-9 codes 250.0-250.9.

Data Source

Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health


Diabetes Hospital Discharges (Age-adjusted Rates) by Local Health District, Utah, 2019-2020

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confidence limits

More rural and frontier local health districts have higher age-adjusted rates of hospitalizations due to diabetes.
Local Health DistrictAge-adjusted Rate per 10,000Lower LimitUpper Limit
Record Count: 14
Bear River10.69.511.7
Central12.811.214.7
Davis County9.38.610.1
Salt Lake County11.511.112.0
San Juan15.813.218.8
Southeast11.610.612.6
Southwest5.23.87.0
Summit15.313.317.6
Tooele16.614.219.2
TriCounty10.29.610.8
Utah County7.05.19.4
Wasatch12.611.713.6
Weber-Morgan5.23.08.4
State of Utah10.610.311.0

Data Notes

ICD-10 codes E10-E14. Prior to 2015, ICD-9 codes 250.0-250.9.   Age-adjusted to the U.S. 2000 standard population. [[br]] [[br]] *Use caution in interpreting the rate for Wasatch County. The estimate has a relative standard error greater than 30 percent and does not meet UDOH standards for reliability.

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, IBIS Version 2020


Diabetes Hospital Discharges (Age-adjusted Rates) by Utah Small Area, 2017-2020

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confidence limits

The top 3 small areas that have the highest age-adjusted rates of diabetes hospital discharge are: Kearns V2 (21.0), Provo (West City Center) (20.9), Taylorsville (East)/Murray (West) (19.7).
Utah Small AreasAge-adjusted Rate per 10,000Lower LimitUpper LimitNote
Record Count: 100
Brigham City14.912.617.6
Box Elder Co (Other) V212.39.415.9
Tremonton10.68.213.5
Logan V29.68.211.1
North Logan14.411.717.5
Cache (Other)/Rich (All) V27.35.69.3
Hyrum9.76.613.9
Smithfield9.77.113.0
Ben Lomond14.713.116.3
Weber County (East)6.85.58.2
Morgan County7.14.810.1
Ogden (Downtown)18.316.220.6
South Ogden12.110.413.9
Roy/Hooper13.311.715.1
Riverdale10.48.512.5
Clearfield Area/Hooper13.111.714.7
Layton/South Weber8.97.810.0
Kaysville/Fruit Heights7.46.18.9
Syracuse8.96.911.2
Centerville8.86.711.4
Farmington6.95.29.0
North Salt Lake9.57.312.2
Woods Cross/West Bountiful10.87.914.3
Bountiful10.08.611.5
SLC (Rose Park)14.312.316.5
SLC (Avenues)3.82.55.5
SLC (Foothill/East Bench)2.61.74.0
Magna13.811.516.4
SLC (Glendale) V215.412.918.4
West Valley (Center)14.813.116.7
West Valley (West) V214.712.317.5
West Valley (East) V217.515.619.5
SLC (Downtown) V218.816.521.3
SLC (Southeast Liberty)6.04.47.9
South Salt Lake19.116.522.0
SLC (Sugar House)12.410.514.4
Millcreek (South)6.44.98.3
Millcreek (East)4.83.66.4
Holladay V27.55.99.5
Cottonwood6.75.58.0
Kearns V221.018.723.6
Taylorsville (E)/Murray (W)19.717.522.1
Taylorsville (West)15.413.417.6
Murray14.512.616.7
Midvale13.511.515.8
West Jordan (Northeast) V213.411.315.8
West Jordan (Southeast)12.410.614.5
West Jordan (W)/Copperton10.48.612.5
South Jordan V28.16.79.7
Daybreak8.56.411.2
Sandy (West)12.110.214.3
Sandy (Center) V212.710.714.9
Sandy (Northeast)4.83.56.4
Sandy (Southeast)5.84.57.4
Draper9.78.111.5
Riverton/Bluffdale8.77.310.4
Herriman8.06.49.8
Tooele County (Other)10.07.712.7
Tooele Valley15.513.817.4
Eagle Mountain/Cedar Valley11.89.115.0
Lehi10.28.711.8
Saratoga Springs6.24.68.2
American Fork8.87.410.4
Alpine2.00.84.0*Use caution in interpreting.
Pleasant Grove/Lindon10.28.811.7
Orem (North)13.311.315.6
Orem (West)11.810.013.9
Orem (East)7.45.79.4
Provo/BYU6.75.38.4
Provo (West City Center)20.918.024.1
Provo (East City Center)15.011.619.0
Salem City8.15.511.6
Spanish Fork11.910.113.9
Springville7.25.78.9
Mapleton6.74.310.0
Utah County (South) V210.27.213.9
Payson14.412.017.1
Park City4.33.15.8
Summit County (East)8.46.011.5
Wasatch County7.45.99.2
Daggett and Uintah County17.215.019.5
Duchesne County19.616.523.2
Nephi/Mona11.28.015.4
Delta/Fillmore18.414.423.1
Sanpete Valley11.29.013.8
Central (Other)14.612.217.4
Richfield/Monroe/Salina11.69.014.7
Carbon County18.715.921.9
Emery County15.912.120.4
Grand County2.81.44.9
Blanding/Monticello6.03.69.4
San Juan County (Other)9.56.214.1
St. George13.011.814.3
Washington Co (Other) V215.612.020.0
Washington City9.47.611.6
Hurricane/La Verkin14.412.017.1
Ivins/Santa Clara7.45.59.8
Cedar City9.88.411.4
Southwest LHD (Other)11.79.614.0
State of Utah11.110.911.3

Data Notes

ICD-10 codes E10-E14. Prior to 2015, ICD-9 codes 250.0-250.9.   A description of the Utah Small Areas may be found on IBIS at the following URL: https://ibis.health.utah.gov/resource/Guidelines.html. *Use caution in interpreting; the estimate has a coefficient of variation > 30% and is therefore deemed unreliable by Utah Department of Health standards. Consider aggregating years to decrease the relative standard error and improve the reliability of the estimate.

Data Source

Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health


Hospitalization With Diabetes as the Primary Diagnosis (Crude Rates), Utah, 2016-2020

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confidence limits

In Utah, crude rates of hospitalization due to diabetes have remained relatively the same from 2016-2020.
YearInpatient Hospital Visits per 10,000 PopulationLower LimitUpper Limit
Record Count: 5
20169.69.310.0
201710.09.610.3
201810.610.311.0
201911.110.711.4
202010.310.010.7

Data Notes

ICD-10 codes E10-E14. Prior to 2015, ICD-9 codes 250.0-250.9.

Data Source

Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health


Inpatient Hospital Visits per 10,000 Population (Age-adjusted Rates), Utah, 2016-2020

::chart - missing::
confidence limits

Age-adjusted rates for inpatient hospital discharges due to diabetes have remained relatively similar over the past 5 years.
YearAge-adjusted Rate per 10,000Lower LimitUpper Limit
Record Count: 5
201610.29.810.6
201710.510.210.9
201811.210.811.5
201911.711.312.1
202011.010.611.4

Data Notes

ICD-10 codes E10-E14. Prior to 2015, ICD-9 codes 250.0-250.9.   Age-adjusted to the U.S. 2000 standard population.

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, IBIS Version 2020

References and Community Resources

[http://www.diabetes.org American Diabetes Association] Diabetes Prevention Program[[br]] [https://www.niddk.nih.gov/health-information/diabetes?dkrd=lgdmn0026 National Diabetes Information Clearinghouse] [http://www.cdc.gov/diabetes Division of Diabetes Translation, Centers for Disease Control and Prevention] [http://www.diabeteseducator.org American Association of Diabetes Educators][[br]] [https://www.facebook.com/aadeutah Local Chapter Facebook Page] Much of the information for this indicator was taken from the American Diabetes Association [http://www.diabetes.org/resources/statistics website]. Information on registering for self-management prediabetes and diabetes programs can be found at [http://livingwell.utah.gov/index.php]. National Diabetes Education Program http://www.ndep.nih.gov National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov Office of Disease Prevention and Health Promotion http://odphp.osophs.dhhs.gov National Hospital Discharge Report http://www.cdc.gov/nchs/data/ad/ad385.pdf

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.

Page Content Updated On 11/16/2021, Published on 11/18/2021
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 21 January 2022 12:55:16 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Thu, 18 Nov 2021 10:10:43 MST