Abstract
OBJECTIVES: To evaluate the impact of chronic diabetes on 42-day hospital readmission rates and hospitalization costs following hospital delivery discharge. METHODS: Using 2016-2019 data from the Hospital Cost and Utilization Project Nationwide Readmissions Database, we conducted a propensity score matched analysis comparing individuals with and without chronic diabetes. Given the strong relationship between severe maternal morbidity and readmission, we used an exact match for severe maternal morbidity during the delivery hospitalization. The study evaluated three outcomes: (1) readmission rates within 42 days of discharge from the delivery hospitalization, (2) total hospitalization costs during the delivery and readmissions within 42 days, and (3) total hospitalization costs for readmission hospitalizations. RESULTS: Adjusted analyses showed 61% [adjusted Odds Ratio: 1.61; Confidence Interval: (1.52, 1.71)] higher rates of postpartum hospital readmission within 42 days (4.49% vs. 2.85%; p < 0.001) and 24% higher total delivery hospitalization costs plus the cost of readmission among individuals with chronic diabetes relative to individuals without diabetes ($9,047 vs. $7,296; p < 0.001). Hospital readmissions costs were higher for individuals with diabetes compared with individuals without diabetes at the time of delivery ($9,136 vs. $8,363; p = 0.03). CONCLUSIONS FOR PRACTICE: Continued efforts to prevent and control chronic diabetes may be important for prevention of postpartum hospital readmissions and increased associated costs.