Patient characteristics by DM type.

BackgroundDiabetes mellitus (DM) imposes substantial healthcare costs with documented disparities among African Americans and Hispanic patients. To inform care delivery and resource allocation, this study identified hospitalization cost predictors among African American and Hispanic patients with diabetes in Southeastern Virginia.MethodsWe analyzed 6,011 hospital discharges from the Virginia Health Information database (2016–2020) for adults aged 18–85 with diabetes. Discharges were classified by Medicare Severity Diagnosis-Related Groups: DM with complications/comorbidities (DCC, n = 3,328), DM with major complications/comorbidities (DMCC, n = 1,518), and DM without major complications/comorbidities (DWO, n = 1,165). Because cost distributions were right-skewed (skewness 3.5–8.24), we used log-linear regression with robust standard errors and back-transformed coefficients to percentage changes.ResultsMean age differed by classification: DWO 38.7 ± 17.2 years, DCC 47.4 ± 17.4, DMCC 54.9 ± 17.4. The cohort was predominantly African American (98.2–99.1%). For DWO, urgent admission was the strongest predictor, associated with 239.5% higher costs versus emergency admissions (95% CI, 220.8–258.2; p ConclusionsAdmission type particularly urgent admissions among patients without major complications, was a key cost driver. Findings support risk stratification in all emergency departments, with priority in systems serving large proportions of minority patients. Heterogeneous readmission effects across classifications indicated the need for nuanced quality metrics. These results provided baseline data for predictive modeling to improve diabetes care and reduce disparities in minority populations.