Emergency Department Visits for Diabetic Adults Aged 18 Years and Older in Florida

BACKGROUND:  Diabetes is a public health problem of increasing concern in the United States.  The incidence of diabetes, and the number of emergency department (ED) visits for diabetes care have increased in recent years.  This study examines the characteristics of populations in Florida who have obtained diabetes care at an ED, as well as their discharge status.

METHODS:  The number of ED visits in 2012 among adults aged 18 years and older with diabetes (ICD-9 code: 250) was obtained from hospital ambulatory and ED data.  The total population with diabetes was estimated using the Behavioral Risk Factor Surveillance System (BRFSS) survey.  BRFSS data were weighted to be representative of all adults with diabetes in Florida.  State estimates and 95% confidence intervals (CIs) were calculated using SAS v9.3.

RESULTS:  In 2012, 11.4% of adults were diagnosed with diabetes in Florida.  The mean age at diagnosis was 51 years old.  People aged 65 and older had a significantly higher diabetes prevalence rate compared to other age groups.  Among approximately 1,734,984 adults with diabetes, the rate of ED visits for diabetes care was 196 per 10,000 in 2012.  The highest ED visit rate was among those aged 18-44.  Among ED visits for diabetes care, there was no significant difference in the rate between males (186 per 10,000) and females (207 per 10,000); however, the rates were higher for blacks (417 per 10,000) than whites (152 per 10,000).  The major primary payers for ED visits for diabetes were Medicare (38.3%); uninsured (24.2%); Medicaid (18.6%); private insurance (15.4%); and government paid (2.9%). The majority (93.4%) of diabetic patients presenting at an ED were discharged to go home; 3.9% left hospital against medical advice or discontinued care, 2.7% were transferred to hospital or other health care facility; and 0.02% died.

CONCLUSIONS:  Blacks, low income and uninsured diabetic patients have a higher rate of ED visits for their diabetes care.  There was no significant difference in the rate between males and females.  This study provides background data for future studies by diabetes programs related to ED usage.