Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States

J Diabetes Complications. 2015 Mar;29(2):192-5. doi: 10.1016/j.jdiacomp.2014.11.005. Epub 2014 Nov 25.


Aims: The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics.

Methods: We accessed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006 to 2011.

Results: Emergency Department: Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization: Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM, and infection was responsible for over $48 billion dollars in aggregate hospital charges.

Conclusions: Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes.

Keywords: Diabetes mellitus; Economics; Emergency department; Hospitalization; Infection.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Cohort Studies
  • Community-Acquired Infections / complications
  • Community-Acquired Infections / economics
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / therapy*
  • Costs and Cost Analysis
  • Databases, Factual
  • Diabetes Complications / economics
  • Diabetes Complications / epidemiology
  • Diabetes Complications / therapy*
  • Emergency Service, Hospital
  • Health Care Costs / trends
  • Hospitalization* / economics
  • Hospitalization* / trends
  • Humans
  • Incidence
  • Insurance, Health
  • Length of Stay
  • Patient Acceptance of Health Care*
  • Pneumonia / complications
  • Pneumonia / economics
  • Pneumonia / epidemiology
  • Pneumonia / therapy
  • Retrospective Studies
  • Sepsis / complications
  • Sepsis / economics
  • Sepsis / epidemiology
  • Sepsis / therapy
  • Skin Diseases, Infectious / complications
  • Skin Diseases, Infectious / economics
  • Skin Diseases, Infectious / epidemiology
  • Skin Diseases, Infectious / therapy
  • United States / epidemiology
  • United States Agency for Healthcare Research and Quality
  • Urinary Tract Infections / complications
  • Urinary Tract Infections / economics
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / therapy