Utilization of Exercise and Dietary Counseling Among Hospitalized Diabetic Patients: Using NIS Data

Background: Exercise and dietary counseling are often delivered to prevent and manage diabetes and other chronic diseases, such as obesity. In this study, we examine [1] trends in utilization of exercise and dietary counseling among hospitalized diabetic patients between the years 2011-2014, and [2] payer differences in the average length of stay and in-patient associated costs. Methods: We used four years of the National Inpatient Sample (NIS) data. Hospitalization stays, comorbidities including obesity and coronary artery disease, and counseling were defined using the International Classification of Diseases 9 codes. Descriptive analysis was performed to study trends in the utilization of counseling among hospitalized diabetic patients. Sociodemographic factors include age, gender, race, and payer. Results: Over the study years, the proportion of hospitalized diabetic patients receiving exercise and dietary counseling increased from 3.93 in 2011 to 4.67 in 2014. All age, race, and payer groups show increased trends in the proportion of the counseling utilization over the years. However, the average length of stay decreased from 5.49 to 5.27 between 2011 and 2014, while the average in-patient costs per hospitalization increased from $12,760.17 in 2011 to $13,852.16 in 2014. Conclusions: Results show an increasing trend in exercise and dietary counseling utilization in an inpatient sample across the years 2011-2014. The increased trend is the same for all sociodemographic and payer types. The average in-patient costs have increased over the study years, but the amount varied by payer type. Medicare and private insurance had the highest in-patient costs associated with the counseling among diabetic inpatients.