Diabetes-related hospital mortality in the U.S. A pooled cross-sectional study of the National Inpatient Sample

Alva O. Ferdinand, Marvellous A. Akinlotan, Timothy Callaghan, Samuel D. Towne, Jane Bolin

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Aims: Despite advancements in the diagnosis and treatment of diabetes in the U.S., place-based disparities still exist. The purpose of this study is to determine place-based and other individual-level variations in diabetes-related hospital deaths. Methods: A pooled cross-sectional study of the 2009–2015 National Inpatient Sample was conducted to examine the odds of a diabetes-related hospital death. The main predictors were rurality and census region. Individual-level socio-demographic factors were also examined. Results: Approximately 1.5% (n = 147,069) of diabetes-related hospitalizations resulted in death. In multivariable analysis, the odds of diabetes-related hospital deaths increased across the urban-rural continuum, except for large fringe metropolitan areas, with the highest odds of such deaths occurring among residents of micropolitan (OR = 1.16, 95% C.I. = 1.14, 1.18) and noncore areas (OR = 1.21, 95% C.I. = 1.19, 1.24). Compared to residents of the Northeast, residents in the South, West and Midwest regions were significantly more likely to experience a diabetes-related hospital death. Asian or Pacific Islanders, Medicaid-covered patients and the uninsured were also more likely to die during a diabetes-related hospitalization. Conclusions: Place-based disparities in diabetes-related hospital deaths exist. Targeted focus should be placed on the control of diabetic complications in the South, West and Midwest census regions, and among rural residents.

Original languageEnglish (US)
Pages (from-to)350-355
Number of pages6
JournalJournal of Diabetes and its Complications
Issue number5
StatePublished - May 2019


  • Census regions
  • Diabetes
  • Disparities
  • Mortality
  • Population health
  • Rurality

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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