1074-P: Variation in Ambulatory Care Sensitive Condition-Related Emergency Department Use among Adults with Diabetes over 2008-2014

There are scarce data on trends in potentially preventable emergency department (ED) use among adults with diabetes. Using data from the National Emergency Department Database and American Community Survey, we estimated percent change in rates of ED visits for diabetes-related Ambulatory Care Sensitive Conditions (ACSCs) (short-term complications [STC], long-term complications [LTC], uncontrolled diabetes, and lower extremity ulcer and inflammation [LEUI]) per 100,00 persons over 2008-2014 by age, sex, rural/urban status, region, and insurance. We identified visits using the presence of relevant ICD-9 codes for primary diagnoses. Overall rates of ED visits increased for STC (by 60.0%), uncontrolled diabetes (27.4%), and LEUI (35.5%) (Table 1). These increases were observed across all age groups with greatest increases in those 45-64 years, but were not substantially different by gender, rural/urban, region, or insurance type. Overall rates of ED visits for LTC decreased by 8.7%, with the greatest decreases among older, rural, Northeastern, and Medicare and privately-insured adults. These results imply ambulatory diabetes management prior to the Affordable Care Act successfully reduced ED use for LTC over 2008-14, but not for other outcomes, especially for middle-aged populations. Disclosure T. S. Uppal: Stock/Shareholder; Self; Gilead Sciences, Inc., Lexicon Pharmaceuticals, Inc., Mesoblast Ltd. G. Fernandes: Employee; Self; Merck & Co., Inc., Employee; Spouse/Partner; Janssen Research & Development, LLC, Stock/Shareholder; Self; Merck & Co., Inc., Stock/Shareholder; Spouse/Partner; Janssen Research & Development, LLC. J. Haw: None. M. K. Shah: None. S. Turbow: Research Support; Self; Merck & Co., Inc. P. K. Chehal: None. S. Rajpathak: Employee; Self; Merck Sharp & Dohme Corp. K. Narayan: None. M. K. Ali: Advisory Panel; Self; Bayer Inc., Other Relationship; Self; Merck & Co., Inc.