Introduction and Objective: Diabetes-related preventable hospitalizations (DRPH) are associated with low socioeconomic status and the Social Vulnerability Index (SVI) is a framework for studying the impact of social vulnerability on health outcomes at the county level. However, there is paucity of data on the impact of social vulnerability on DRPH. We examined the association between county-level SVI and DRPH focusing on short- and long-term complications, lower extremity amputations, and uncontrolled diabetes in California.Methods: In this retrospective cross-sectional study, we linked risk-adjusted DRPH (RA-DRPH) for patients aged ≥20 years with SVI data for all counties in California in 2022. SVI values range from 0 to 1, with higher values indicating greater social vulnerability. SVI percentile rankings were divided into four quartiles (1st quartile [SVI-Q1], least vulnerable; SVI-Q4, most vulnerable). RA-DRPH rate per 100,000 with 95% confidence intervals (CI) were stratified by the SVI quartiles. A negative impact by SVI was characterized by a higher RA-DRPH rate in SVI-Q4 than in the SVI-Q1 with non-overlapping CI.Results: For short-term complications and uncontrolled diabetes, there was no significant difference between SVI-Q4 and SVI-Q1. SVI-Q4 had higher RA-DRPH rate for long-term complications (114.7; CI: 98.1-131.3) than SVI-Q1 (71.5; CI: 54.9-88.1), with an excess RA-DRPH rat of 43.2. For lower extremity amputation, SVI-Q4 had higher RA-DRPH rate (40.7; CI: 33.9-47.5) than SVI-Q1 (26.7: CI: 19.8-33.3) with an excess of 14 RA-DRPH rate in SVI-Q4. For RA-DPRH for any of the four complications, SVI-Q4 (240; CI: 207.6-273) had higher rate than SVI-Q1 (170.1; CI: 137.4-202.8) with an excess of 70 RA-DRPH.Conclusion: Higher county-level social vulnerability is associated with increased DRPH in California. The allocation of more resources to counties with higher SVIs can potentially reduce DRPH in these counties.
B. Biney: None. A.O. Amoah: None. C. Amanze: None. N.A. Addo-Quaye: None. E. Nkrumah: None. A. Rashid: None. H.E. Brown: None.
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