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BACKGROUND: About 1.1 million Michigan adults have diabetes. Michigan’s Medicaid programs are funded by state and federal dollars and serve a vulnerable adult population at risk for diabetes. Medicaid claims analysis provides a unique and powerful perspective on key components of health care. We report on indicators of diabetes burden and health care utilization using Medicaid claims.
METHODS: The population under surveillance was composed of adult Medicaid beneficiaries (18-64 years) continuously enrolled for 11 or 12 months with no other insurance during each individual calendar year (2007-2012). Diabetes cases were defined based on an adaptation of the 2012 Health Plan Employer Data Information Set (HEDIS®) criteria. Surveillance of diabetes prevalence and diabetes-related treatment and procedures by demographic characteristics and geography was conducted for each year.
RESULTS: Diabetes prevalence among the Michigan adults served by Medicaid programs was 9.6% for 2012. Among adults with diabetes, ~5% had at least one diabetes self-management education session in 2012; this was consistent for the six study years. The 2012 acute inpatient hospitalization rate for any-listed diabetes diagnosis was 350 per 1000 persons with diabetes. The emergency department (ED) visit rate for any-listed diabetes diagnosis was 117 per 100 persons with diabetes. The inpatient hospitalization rate increased by 24% from 2007 to 2009, but returned close to the 2007 rate by 2012; however, the ED visit rate increased by ~44% from 2007 to 2009 and remained consistently high. Disparities related to inpatient hospitalization and emergency department visits-related indicators were observed among racial/ethnic groups, gender, and urban versus rural settings.
CONCLUSIONS: Medicaid claims are a robust data source for diabetes surveillance. Surveillance of these adults will provide more information on the burden of diabetes among low-income populations in Michigan. Diabetes control interventions, programs, and messaging may be better targeted towards these citizens based on diabetes-related health care utilization.