EPH31 Risk of hospital admission or emergency department presentation due to diabetes complications: A retrospective cohort study in Tasmania, Australia

Background: Timely information regarding the risk of admission due to diabetes complications is required for policy planning as diabetes complications are responsible for the large burden of disease experienced by people living with diabetes in Australia.

Aim: To estimate the risk of hospitalisation or emergency department presentation due to complications in people with diabetes, compared to their non-diabetes counterparts.

Method: This matched cohort study used a linked dataset in Tasmania, Australia for the 2004-2017 period. People with diabetes (n=45,378) were matched on age, sex, and geographical regions with people without diabetes (n=90,756) based on propensity score matching. The risk of admission related to each complication was estimated using negative binomial regression.

Results: In people with diabetes, the incidence rates of admission per 10,000 person-years were considerable, especially for macrovascular complications (ranged from 58.0 [ischemic heart disease] to 333.6 [heart failure]). The adjusted incidence rate ratios of admission related to complications were: retinopathy 63.01 (29.13, 136.32), lower extremity amputation 15.88 (12.60, 20.02), foot ulcer/gangrene 13.32 (11.43, 15.51), transplant 12.75 (4.39, 37.03), nephropathy 10.37 (7.80, 13.80), dialysis 7.71 (4.55, 13.09), vitreous hemorrhage 7.69 (4.73, 12.51), kidney failure 5.23 (3.94, 6.94), heart failure 5.12 (4.72, 5.55), fatal myocardial infarction 4.61 (3.06, 6.94), angina pectoris 2.76 (2.57, 2.97), fatal stroke 2.76 (1.73, 4.38), ischemic heart disease 2.45 (2.23, 2.69), non-fatal myocardial infarction 2.41 (2.23, 2.60), neuropathy 2.26 (2.07, 2.47), non-fatal stroke 2.25 (2.07, 2.45), blindness/low vision 1.75 (1.09, 2.82).

Conclusion: Our results demonstrated the high demand on hospital services due to diabetes complications (especially macrovascular complications) and also highlighted the importance of preventing and properly managing microvascular complications. These findings will support future resource allocation to reduce the predicted increasing burden of diabetes in Australia.