Austin, Andrea M. and Leggett, Christopher G. and Schmidt, Peter and Bolin, Paul and Nelson, Eugene C. and Oliver, Brant J. and King, Ashleigh C. (2022) Utilization Patterns and Outcomes of People With Diabetes and COVID-19: Evidence From United States Medicare Beneficiaries in 2020. Frontiers in Clinical Diabetes and Healthcare, 3. ISSN 2673-6616
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Abstract
Objective: Determine differences in utilization patterns, disease severity, and outcomes between patients with and without diabetes mellitus diagnosed with COVID-19 in 2020
Research Design and Methods: We used an observational cohort comprised of Medicare fee-for-service beneficiaries with a medical claim indicating a COVID-19 diagnosis. We performed inverse probability weighting between beneficiaries with and without diabetes to account for differences in socio-demographic characteristics and comorbidities.
Results: In the unweighted comparison of beneficiaries, all characteristics were significantly different (P<0.001). Beneficiaries with diabetes were younger, more likely to be black, had more comorbidities, higher rates of Medicare-Medicaid dual-eligibility, and were less likely to be female. In the weighted sample, hospitalization rates for COVID-19 among beneficiaries with diabetes was higher (20.5% vs 17.1%; p < 0.001). Outcomes of hospitalizations were similarly worse among beneficiaries with diabetes: admissions to ICU during hospitalizations (7.78% vs. 6.11%; p < 0.001); in-hospital mortality (3.85% vs 2.93%; p < 0.001); and ICU mortality (2.41% vs 1.77%). Beneficiaries with diabetes had more ambulatory care visits (8.9 vs. 7.8, p < 0.001) and higher overall mortality (17.3% vs. 14.9%, p < 0.001) following COVID-19 diagnosis.
Conclusion: Beneficiaries with diabetes and COVID-19 had higher rates of hospitalization, ICU use and overall mortality. While the mechanism of how diabetes impacts the severity of COVID-19 may not be fully understood, there are important clinical implications for persons with diabetes. A diagnosis of COVID-19 leads to greater financial and clinical burden than for their counterparts, persons without diabetes, including perhaps most significantly, higher death rates.
Item Type: | Article |
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Subjects: | Journal Eprints > Medical Science |
Depositing User: | Managing Editor |
Date Deposited: | 26 Nov 2022 04:53 |
Last Modified: | 27 Feb 2024 04:18 |
URI: | http://repository.journal4submission.com/id/eprint/320 |