Total and excess bed-days in people with diabetes in Australia

This study was conducted to describe the annual bed-day rate and excess bed-day rate related to diabetes and to investigate the main diagnoses that account for the excess bed-days in people with diabetes in Australia.

For the diabetes population, we linked data from the Australian National Diabetes Services Scheme to the National Morbidity Inpatient Register (NMIR) and the National Death Index from 2014 to 2017. General population data were sourced from the NMIR. We used quasi-Poisson regression to estimate rates by adjusting for age, sex and fiscal year.

The adjusted annual all-cause bed-day rate per 100,000 people was 323,087 (95% CI: 303,186, 344,295) for the diabetes cohort and 196,363 (192,178, 200,639) for the general population. This resulted in an annual all-cause excess bed-day rate of 126,724 (106,003, 147,445) per 100,000 people with diabetes. Approximately 42% of excess bed-days were attributed to infections, endocrine disorders and cardiovascular diseases. Foot infection had the largest single-disease annual excess bed-day rate for foot infection at 8787 (7976, 9597) per 100,000 people with diabetes and accounted for more excess bed-days than most broad disease categories. Excess bed-days were greater among women with diabetes compared to men with diabetes (p-value <0.01).

People with diabetes experienced a higher rate of bed-days compared to the general population, with traditional complications significantly explaining most of the excess number of bed-days observed. The major impact of foot infection on hospital burden demands greater attention be paid to the prevention and early management of foot complications.