Abstract
This study is a database analysis of health services outcomes for diabetic myocardial infarction inpatients admitted in non federal hospitals. Relatively little or nothing is known about the outcomes of hospital inpatients with both MI (Myocardial Infarction) and T2D (Type 2 Diabetes). To evaluate the effects of patient and hospital characteristics on patient length of stay (LOS) in this population, we analyzed database for 2006 Health care Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) using the International Classification of Diseases, Ninth Revision (ICD-9) codes (41000, 410001, 410011 for MI) and (25000 for diabetes). Included in this study were patients with age ranged from 20years to 84years.The study used descriptive analysis, bi-variate and linear regression to identify the association of patient and hospital characteristics with the inpatient diabetic MI LOS. The study had sufficient power > .80. The statistical analysis showed that the older patients stayed longer in the hospital than their younger counterparts, F (4, 2548) = 5.936, p < .001. Females stayed longer days in the hospital than their male counterparts, X2 (1, N = 2773) = 187.02, p < .001. The adjusted dummy coded regression results on the effects of variables on LOS was significant for Hispanics (B = .809, p = .021) when compared to Whites. Other predictors are Medicare (B = 2.227, p < .001), private including HMO (B = .899, p < .001), and self pay (B = 1.059, p = .009) when compared to Medicare; urban hospitals (B = -1.031, p = .014) when compared to rural teaching status; Midwest (B = -1.681, p < .001) and West (B = -1.662, p = .001) hospital regions when compared to the hospitals in the Northeast region of the country. Further adjusted regression with comorbidities on LOS was significant for coronary atherosclerosis (B = -1.386, p < .001) and hypertension (B = -2.079, p < .001) when compared to T2D uncomplicated. Atrial fibrillation (B = 1.500, p = .011) and cardiogenic shock (B = -2.195, p = .003) were significant when compared to cardiac arrest. Diabetics are to be screened for complications on admissions. In conclusion, equity in care warrants serious considerations in the formulation of National policies and programs to improve the quality of health care of inpatients with MI and T2D.
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