Disparities in Hospitalization for Diabetes Among Persons With and Without Co-occurring Mental Disorders

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Abstract

Objectives

This article describes differences in hospitalization for diabetes among persons with diabetes who did or did not have co-occurring mental illness and who presented in the emergency department of a large county hospital located in the Southwest.

Methods

Four and a half years of administrative data were used and consisted of all emergency visits for diabetes (N=4,275) made by persons with and without co-occurring mental disorders. The dependent variable was whether the emergency visit resulted in hospitalization. Generalized estimating equations adjusted for age, gender, and race were used to identify differences in hospital admission between those with no co-occurring mental illness and those with any mental illness, including psychotic illness (schizophrenia or bipolar disorder) and nonpsychotic illness (depression or anxiety).

Results

Persons with diabetes and co-occurring mental illness were less likely than those without mental illness to be hospitalized after an emergency department visit (adjusted odds ratio of .65). Persons with diabetes and co-occurring nonpsychotic disorders were at especially high risk (adjusted odds ratio of .55) to not be admitted.

Conclusions

This study provides more evidence demonstrating disparities in physical health treatment for persons with co-occurring mental disorders. Persons with diabetes and anxiety or depression appear to be at greatest risk in this service setting. Further research is needed to identify persons with mental illness who receive poor physical health care to understand the reasons for disparities and to devise interventions to ensure appropriate medical care for those with mental illness.

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