{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:11:21Z","timestamp":1777983081864,"version":"3.51.4"},"reference-count":40,"publisher":"American Diabetes Association","issue":"5","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2003,5,1]]},"abstract":"<jats:p>OBJECTIVE\u2014To examine the impact of comorbid conditions on preventable hospitalizations among Medicare beneficiaries aged \u226565 years with type 2 diabetes.<\/jats:p>\n               <jats:p>RESEARCH DESIGN AND METHODS\u2014Data were drawn from the 1999 Medicare Standard Analytic Files, a 5% nationally representative random sample of Medicare beneficiaries. The analysis sample included 193,556 Medicare beneficiaries aged \u226565 years with type 2 diabetes (ICD-9-CM codes 250.xx) who were enrolled in fee-for-service Medicare. Preventable hospitalization was assessed by measuring ambulatory care-sensitive conditions, an accepted measure of hospitalizations that could have been prevented with appropriate outpatient care. Multivariable analyses controlled for demographics; mortality; renal, ophthalmic, or neurological manifestations of diabetes; type of physician providing the outpatient care; and per capita community-level indicators of income and hospital beds.<\/jats:p>\n               <jats:p>RESULTS\u2014Ninety-six percent of beneficiaries in the sample had a comorbidity, and 46% had five or more comorbidities. Among beneficiaries with type 2 diabetes, cardiovascular-related comorbidities were common and accounted for increased odds of preventable hospitalization, controlling for other factors. The likelihood of a preventable hospitalization increased in the presence of a claim for comorbid congestive heart failure, cardiomyopathy, coronary atherosclerosis, hypertension, or cardiac dysrythmias. Noncardiovascular comorbidities associated with a greater likelihood of preventable hospitalization included chronic obstructive pulmonary disease, asthma and lower respiratory disorders, Alzheimer\u2019s disease\/dementia, personality\/anxiety disorders, depression, and osteoporosis. Our data suggest that nearly 7% of all hospitalizations could be avoided.<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014These findings support the need for improved outpatient care strategies to reduce the impact of comorbidity on unnecessary hospitalization in patients aged \u226565 years with type 2 diabetes.<\/jats:p>","DOI":"10.2337\/diacare.26.5.1344","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T22:51:27Z","timestamp":1173135087000},"page":"1344-1349","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":85,"title":["Preventable Hospitalization Among Elderly Medicare Beneficiaries With Type 2 Diabetes"],"prefix":"10.2337","volume":"26","author":[{"given":"Marlene R.","family":"Niefeld","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel B.","family":"Braunstein","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Robert Wood Johnson Clinical Scholars Program, Johns Hopkins Medical Institution, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert W.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher D.","family":"Saudek","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy E.","family":"Weller","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard F.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","reference":[{"key":"2022031216480814400_R1","doi-asserted-by":"crossref","unstructured":"Redelmeier DA, Tan SH, Booth GL: The treatment of unrelated disorders in patients with chronic medical diseases. 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