Abstract 230: Exploring the Prevalence and Factors that Affect Patients with Both Diabetic and Myocardial Infarction: Teaching Versus Non-Teaching Hospitals

Abstract

Background: There has been an increasing prevalence of myocardial infarction (MI) inpatients with type 2 diabetes (T2D). Relatively very little research has been reported on the health services outcomes differences between teaching and non teaching hospitals with regards to length of stay (LOS) of inpatients with both MI and T2D. This study examined factors that affect the LOS differences of inpatients with both MI and T2D in teaching and non teaching hospitals. These factors include patient characteristics (age, gender, ethnicity, education, income, insurance, cost, comorbidities, MI severity, treatment procedures) and hospital characteristics (bed size, location, ownership and region). Method: Data from 2008 National Inpatients Statistics (NIS) under the Agency for Healthcare Research and Quality (AHRQ) was retrospectively analyzed. We identified 4,444 patients with diabetic myocardial infarction and seven categories of length of stay in days (1 day or less than one day; 2 days; 3 days; 4 days; 5 to 6 days; 7 to 13 days; 14 days or longer) were used for the analyses. Result: Overall, patients stayed shorter in non teaching hospitals than in teaching hospitals. Age group 65 - 74 was significant (X 2 = 37.294, df = 6, p = .000) for longer stay in teaching hospitals with more females staying longer in teaching (24.9%) than in non teaching (21.3%) hospitals. White ethnic group stayed shorter in non-teaching hospitals than other ethnic groups while patients with income lower than $39,000 stayed longer in non-teaching hospitals than those with higher income. Only Medicare was significant (X 2 = 24.975, df = 6, p = .000) amongst the patients payment methods. Patients with hypertension stayed longer than patients with other comorbidities while severe loss of function for MI severity remained significant (X 2 = 15.181, df = 6, p = .019). Furthermore, length of stay and hospital characteristics for medium and large bed size, urban, government and private-owned, Northeast and Western hospitals were significant (p <.013). Conclusion: In conclusion, this study has shown that there is a significant difference between teaching and non teaching hospitals and these differences are large enough to affect policy changes and this may all be attributed to age, income, and insurance possession. Understanding the relationship between MI and T2D will enable the healthcare professionals to start screening diabetic patients for any coronary artery diseases in order to prevent prolonged length of stay in teaching hospitals. Shorter length of stay equates lower cost of stay, hence availability of needed budget for preventive measures.