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By Sally Crocker

A new study by UNTHSC public health researchers points to important information that may help health care providers, policymakers and insurance payers reduce the risk of preventable hospitalizations for diabetes patients.

The study in PLOS ONE provides insight into the relationship between these hospitalizations and behavioral health conditions like schizophrenia, bipolar disorder, depression, anxiety and drug or alcohol abuse.

Diabetes patients with a co-occurring behavioral health condition were at disproportionately high risk for diabetes-related, potentially preventable hospitalizations. The 20.8 percent of persons with both diabetes and behavioral health conditions experienced 43.6 percent of all diabetes preventable hospitalizations.

An estimated 30.3 million people in the U.S. are living with diabetes, which accounted for about $237 billion in direct medical costs for the year 2017, said Dr. Erica Stockbridge, Assistant Professor of Health Behavior and Health Systems at the UNTHSC School of Public Health, and lead author the PLOS ONE study.

“Costs for diabetes patients are approximately 2.3 times higher than for other patients, often from complications that could be prevented through timely, high-quality, ongoing outpatient care,” Dr. Stockbridge said.

The research team found that schizophrenia and alcohol use disorder increased the potential for hospitalization but not repeat admissions. In contrast to previous studies, the UNTHSC researchers did not find a significant link between anxiety disorders and preventable diabetes hospitalizations.

The team recommend additional study into the unique challenges facing diabetes patients who also suffer from substance abuse. Their hospitalizations and repeat health relapses may be due in large part to “neglect of other areas of their life while spending a significant amount of time obtaining, using or recovering from their substance(s) of choice,” the researchers said.

The groups at greatest risk for experiencing recurring preventable admissions were those with depression, those with drug use disorder and those with multiple behavioral health conditions.

More than one third of persons with co-occurring diabetes and behavioral health conditions were diagnosed with multiple behavioral health conditions, emphasizing the importance of looking at the patient’s total health picture, rather than each mental or physical health concern separately.

“Our findings point to the importance of integrating how diabetes patients’ complex physical and underlying behavioral health needs are screened, diagnosed and addressed,” Dr. Stockbridge said. “When physical and mental health providers and insurance payers are aligned as one team, there are opportunities to develop more encompassing and effective treatment plans that deliver quality care and behavioral interventions outside the hospital.”

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