Hospital length of stay and healthcare costs among African American women due to obesity and diabetic conditions in United States: A model for correlation studies comparing ethnicity, co-morbidities and hospital resources.

Objective: To examine obesity and diabetes associations with United States hospital use and healthcare costs for African American women, to explore the relationship between co-morbidities of interest (obesity and diabetes) and hospital resources [length of stay (LOS) and costs].

Methods: A retrospective, correlation, quantitative analysis for lengths of hospital stay and cost among adult African American women categorized according to their weight status with type 2 diabetes. Healthcare Cost and Utilization Project (HCUP) data which contains the Nationwide Inpatient Sample was used. Focused on 803,163 African American, female inpatients between the ages of 21 and 55 in the United States from 2008 to 2010. Researcher explored the relationship between individual health factors of interest (obesity and diabetes) and the effects on hospital LOS and healthcare costs. All statistical analysis will be performed using Stata v12. All inferential tests will be two-sided and will utilize a 95% significance level. Two separate multiple regressions will be used.

Results: A total of 758,874 records were retained for analysis. The patients in the weighted population ranged in age from 21 to 55 years. The patient LOS ranged from 0 to 333 days. The patients had approximately 2 procedures on average, and presented with approximately 3 chronic conditions on average. The total charges (Cost) ranged from 106 to over 1 million US dollars. The size and direction of the relationship between LOS, healthcare costs and the independent variables of diabetes and obesity suggests that both LOS and health care cost decreased for African American female patients with diabetes or obesity. There is a statistically significant relationship between at least one of the individual health factors of interest (obesity and diabetes) and hospital LOS ( F  = 13,394.00, P  < 0.0005, R 2  = 0.440) and hospital costs ( F  = 10,171.23, P  < 0.0005, R 2  = 0.502).

Conclusions: There is evidence of racial and ethnic disparities in health care quality in hospital treatment of African American patients. After accounting for social determinants and insurance statuses, African Americans may receive lower-quality care than the population at large. African Americans are admitted to the hospital, but services and LOS are shorter than the general population partially due to disparities in evaluating and offering treatment.