• Sujith Ramachandran, Yiqiao Zhang, Tyler J Dunn, Swarnali Goswami, Eric Pittman, Georgianna Mann, and Annie Cafer.
• University of Mississippi School of Pharmacy, 232 Faser Hall, University, MS 38677. Email: sramacha@olemiss.edu.
• Am J Manag Care. 2022 Nov 1; 28 (11): 574580574-580.

ObjectivesThis study aims to estimate the burden of food affordability on diabetes-related preventable hospitalizations among Medicaid enrollees in the United States.Study DesignThis study used a retrospective observational design with Medicaid administrative claims data from 17 states from 2014.MethodsData were linked with county-level social determinants of health (SDOH) from the American Community Survey. The rate of diabetes-related preventable hospitalizations was measured using the Agency for Healthcare Research and Quality's Prevention Quality Diabetes Composite, which includes hospitalization for short-term complications, long-term complications, lower extremity amputations, and uncontrolled diabetes. Multivariable logistic regression was used to predict the occurrence of diabetes-related preventable hospitalization.ResultsAmong the 16 million eligible individuals, diabetes-related preventable hospitalizations were identified at the rate of 1.91 per 1000 individuals and contributed to more than $160 million in charges. Rates were higher among men compared with women (0.25% vs 0.15%; P  < .001) and among Black adults compared with White adults (0.29% vs 0.18%; P  < .001). Compared with individuals residing in counties with low food affordability, those residing in counties with high (odds ratio [OR], 0.84; 95% CI, 0.78-0.91; P  < .001) or medium (OR, 0.85; 95% CI, 0.81-0.90; P  < .001) food affordability had lower odds of hospitalization.ConclusionsThis study provides real-world evidence about the impact of SDOH on diabetes-related preventable hospitalizations. Federal and state policies that can help improve accessibility of healthy foods are needed to ameliorate the burden of diabetes on society.

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