Health Outcome HO.2 Diabetes hospitalization rate per 1,000
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Data Source
Hospitalization and ER data for 2005 – 2007 were accessed via the Health Matters in San Francisco website: http://www.healthmattersinsf.org/index.php. Health Matters in SF compiled the data from California Office of Statewide Health Planning and Development (OSHPD). For more information on these preventable hospitalizations, visit: http://oshpd.cahwnet.gov/HID/Products/PatDischargeData/ResearchReports/PrevntbleHosp/PQIReport.pdf
Explanation and Limitations
This indicator shows San Francisco's hospitalization rate due to uncontrolled diabetes, and short-term and long-term complications from diabetes combined. Data are age-adjusted per 1,000 population. Rates were calculated using population figures from the 2000 U.S. Census. Age standardization allows comparisons across counties or by zip codes that differ in size or age composition.
From the Health Matters in SF website, "According to National Diabetes Education Program, 'diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.' Diabetes can have a harmful effect on most organ systems in the human body; it is a frequent cause of renal disease and lower-extremity amputation, and a leading cause of blindness among working age adults. Persons with diabetes are also at increased risk for ischemic heart disease, neuropathy, and stroke.
The prevalence of diagnosed type 2 diabetes increased sixfold in the latter half of the last century according to the CDC. Diabetes risk factors such as obesity and physical inactivity have played a major role in this dramatic increase. Age, race, and ethnicity are also important risk factors. The CDC estimates the direct economic cost of diabetes in the United States to be about $100 billion per year. This figure does not take into account the indirect economic costs attributable to potential work time lost to diabetes- related illness or premature death."
Diabetes is considered an "Ambulatory Care Sensitive Condition" (ACSC). "The analysis of hospitalizations for by geographic area is an indicator of access to ambulatory care services. ACSCs are 'diagnoses for which timely and effective outpatient care can help to reduce the risks of hospitalization by either preventing the onset of an illness or condition, controlling an acute episodic illness or condition, or managing a chronic disease or condition. (J. Billings, et al., "Impact of Socioeconomic Status on Hospital Use in New York City," Health Affairs, 1993, 12(1): 162-173.)'"
This measure does not identify what barriers are responsible for the differences, nor does it identify whether the barriers are in the health care system or in the preferences and practices of individuals or communities.
Ambulatory care sensitive conditions are just one indicator of inadequate access to health care in San Francisco. Other factors such as health insurance coverage, transportation to and from the health facility, cultural competency or cultural humility of health care providers, hours of operation, length of reimbursement period, cultural and linguistic competency of administrative and intake staff, availability of child care, availability of prevention programs, and employer requirements are among many factors impeding reliable, continuous access to affordable, quality health care.