TY - JOUR
AU - P. Prajapati
AU - M. Barnard
AU - J. P. Bentley
AU - K. Bhattacharya
A1 - 
AB - BACKGROUND: The prevalence of cardiovascular (CVD) and mental health comorbidities (MHD) among individuals with diabetes is increasing. Pathological differences in these comorbidities may lead to differential healthcare utilization. This study’s objectives were to estimate the prevalence of CVD and MHD among older adults with type 2 diabetes (T2DM) and to assess all-cause healthcare utilization among these individuals. METHODS: A retrospective cohort analysis among Medicare-insured older individuals with T2DM was conducted. Four study cohorts were defined based on the presence of CVD and MHD. Healthcare utilization was measured as the number of visits. In addition to descriptive statistics, adjusted generalized linear models were fit and recycled predictions were employed to estimate the incremental utilization among study cohorts. RESULTS: Of 225,165 beneficiaries with T2DM, 53.30% (n=120,003) had neither CVD nor MHD, 23.98% (n=53,992) had CVD but no MHD, 12.05% (n=27,130) had MHD but no CVD, and 10.68% (n=24,040) had both CVD and MHD. Relative to beneficiaries with neither CVD nor MHD, those with CVD but no MHD had 0.11 higher mean inpatient, 2.29 higher mean outpatient, and 0.18 higher mean emergency department (ED) visits annually; those with MHD but no CVD had 0.22 higher mean inpatient, 8.78 higher mean outpatient, and 0.43 higher mean ED visits annually; those with both CVD and MHD had 0.31 higher mean inpatient, 7.53 higher mean outpatient, and 0.59 higher mean ED visits annually. Additionally, when compared to beneficiaries with CVD but no MHD, those with MHD but no CVD had 0.11 higher mean inpatient, 6.49 higher mean outpatient, and 0.25 higher mean ED visits annually. CONCLUSION: Older adults with T2DM and comorbidities use more healthcare services, especially those with MHD. The development and implementation of integrated care systems for management of chronic diseases and associated comorbidities will help in optimizing the use of healthcare resources. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-026-06988-9.
AD - Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, MS, USA. pprajapa@go.olemiss.edu.; Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, MS, USA.; Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, MS,, USA.
AN - 41618199
BT - BMC Geriatr
C5 - Healthcare Disparities
CP - 1
DA - Jan 30
DO - 10.1186/s12877-026-06988-9
DP - NLM
ET - 20260130
IS - 1
JF - BMC Geriatr
LA - eng
N2 - BACKGROUND: The prevalence of cardiovascular (CVD) and mental health comorbidities (MHD) among individuals with diabetes is increasing. Pathological differences in these comorbidities may lead to differential healthcare utilization. This study’s objectives were to estimate the prevalence of CVD and MHD among older adults with type 2 diabetes (T2DM) and to assess all-cause healthcare utilization among these individuals. METHODS: A retrospective cohort analysis among Medicare-insured older individuals with T2DM was conducted. Four study cohorts were defined based on the presence of CVD and MHD. Healthcare utilization was measured as the number of visits. In addition to descriptive statistics, adjusted generalized linear models were fit and recycled predictions were employed to estimate the incremental utilization among study cohorts. RESULTS: Of 225,165 beneficiaries with T2DM, 53.30% (n=120,003) had neither CVD nor MHD, 23.98% (n=53,992) had CVD but no MHD, 12.05% (n=27,130) had MHD but no CVD, and 10.68% (n=24,040) had both CVD and MHD. Relative to beneficiaries with neither CVD nor MHD, those with CVD but no MHD had 0.11 higher mean inpatient, 2.29 higher mean outpatient, and 0.18 higher mean emergency department (ED) visits annually; those with MHD but no CVD had 0.22 higher mean inpatient, 8.78 higher mean outpatient, and 0.43 higher mean ED visits annually; those with both CVD and MHD had 0.31 higher mean inpatient, 7.53 higher mean outpatient, and 0.59 higher mean ED visits annually. Additionally, when compared to beneficiaries with CVD but no MHD, those with MHD but no CVD had 0.11 higher mean inpatient, 6.49 higher mean outpatient, and 0.25 higher mean ED visits annually. CONCLUSION: Older adults with T2DM and comorbidities use more healthcare services, especially those with MHD. The development and implementation of integrated care systems for management of chronic diseases and associated comorbidities will help in optimizing the use of healthcare resources. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-026-06988-9.
PY - 2026
SN - 1471-2318
ST - All-cause healthcare utilization among older adults with type 2 diabetes and cardiovascular and mental health comorbidities
T1 - All-cause healthcare utilization among older adults with type 2 diabetes and cardiovascular and mental health comorbidities
T2 - BMC Geriatr
TI - All-cause healthcare utilization among older adults with type 2 diabetes and cardiovascular and mental health comorbidities
U1 - Healthcare Disparities
U3 - 10.1186/s12877-026-06988-9
VL - 26
VO - 1471-2318
Y1 - 2026
ER -