May 1, 2015

Cost Burden of Potentially Preventable Hospitalizations for Cardiovascular Disease and Diabetes for Asian Americans, Pacific Islanders, and Whites in Hawai’i

Tetine L. Sentell, PhD: Hyeong Jun Ahn, PhD; Jill Miyamura, PhD; Deborah T. Juarez, ScD

Journal of Health Care for the Poor and Underserved

We compared the cost burdens of potentially preventable hospitalizations for cardiovascular disease and diabetes for Asian Americans, Pacific Islanders, and Whites using Hawai’i statewide 2007–2012 inpatient data. The cost burden of the 27,894 preventable hospitalizations over six years (total cost: over $353 million) fell heavily on Native Hawaiians who had the largest proportion (23%) of all preventable hospitalizations and the highest unadjusted average costs (median: $9,117) for these hospitalizations. Diabetes-related amputations (median cost: $20,167) were the most expensive of the seven preventable hospitalization types. After adjusting for other factors (including age, insurance, and hospital), costs for preventable diabetes-related amputations were significantly higher for Native Hawaiians (ratio estimate:1.23; 95%CI:1.05–1.44), Japanese (ratio estimate:1.44; 95%CI:1.20–1.72), and other Pacific Islanders (ratio estimate:1.26; 95%CI:1.04–1.52) compared with Whites. Reducing potentially preventable hospitalizations would not only improve health equity, but could also relieve a large and disproportionate cost burden on some Pacific Islander and Asian American communities.

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