Date of Conferral

2020

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

CHERYL CULLEN

Abstract

Diabetes is a leading cause of hospitalization and readmission in the United States. The 30-day readmission rate for diabetic patients represents substantial costs to the nation’s health care system. The purpose of this quantitative study was to examine the relationship between primary payer status and hospital readmission rates among individuals whose primary or secondary reason for admission was Type 2 diabetes mellitus (T2DM). Secondary data from the Healthcare Cost Utilization Program Nationwide Database of the 2015 National Readmission Database was analyzed. Participants in the data set included 41,068 diabetes patients, 53.8% of whom were female. The average age was 67.26, and the majority had diabetes with complications (62.1%). The Donabedian framework was applied for the analysis. Results of logistic regression analysis showed that possession of Medicare and lack of insurance were significant predictors of being readmitted within 30 days. Women had higher odds of being readmitted within 30 days compared to men. There was no statistically significant relationship between primary payer status and 30-day readmission rates among individuals whose primary or secondary reason for admission was T2DM. Sociodemographic factors such as age, gender, or income did not moderate the relationship between primary payer status and 30-day hospital readmission rates nationally. The study contributes to positive social change by providing hospital administrators with knowledge they can use to implement protocols prior to discharge that may prevent possible readmissions, potentially reducing costs to facilities and improving patient care.

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