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Differential impact of admission type and clinical complexity on diabetes hospitalization costs among African American and hispanic patients in Southeastern Virginia

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  • Ismail El Moudden
  • Asra Amidi
  • Reem Sharaf-Alddin
  • Michael C Bittner
  • Qi Zhang

Abstract

Background: Diabetes mellitus (DM) imposes substantial healthcare costs with documented disparities among African Americans and Hispanic patients. To inform care delivery and resource allocation, this study identified hospitalization cost predictors among African American and Hispanic patients with diabetes in Southeastern Virginia. Methods: We analyzed 6,011 hospital discharges from the Virginia Health Information database (2016–2020) for adults aged 18–85 with diabetes. Discharges were classified by Medicare Severity Diagnosis-Related Groups: DM with complications/comorbidities (DCC, n = 3,328), DM with major complications/comorbidities (DMCC, n = 1,518), and DM without major complications/comorbidities (DWO, n = 1,165). Because cost distributions were right-skewed (skewness 3.5–8.24), we used log-linear regression with robust standard errors and back-transformed coefficients to percentage changes. Results: Mean age differed by classification: DWO 38.7 ± 17.2 years, DCC 47.4 ± 17.4, DMCC 54.9 ± 17.4. The cohort was predominantly African American (98.2–99.1%). For DWO, urgent admission was the strongest predictor, associated with 239.5% higher costs versus emergency admissions (95% CI, 220.8–258.2; p

Suggested Citation

  • Ismail El Moudden & Asra Amidi & Reem Sharaf-Alddin & Michael C Bittner & Qi Zhang, 2026. "Differential impact of admission type and clinical complexity on diabetes hospitalization costs among African American and hispanic patients in Southeastern Virginia," PLOS ONE, Public Library of Science, vol. 21(2), pages 1-20, February.
    • Handle: RePEc:plo:pone00:0342483
    DOI: 10.1371/journal.pone.0342483
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