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PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older

DOMAIN: Seamless Care Coordination

Without access to high quality outpatient diabetes care, certain diabetes conditions can become life-threatening. These complications may result in costly and avoidable inpatient hospital admissions. Inpatient hospital admissions for these complications can be an indicator that diabetes is not being properly prevented or managed.

Explore inpatient hospital admission rates per 100,000 beneficiary months for short-term complications of diabetes in each state. Lower rates are better on this measure.

The purple dashed line represents the median, or middle, of all values reported.

This measure reports state performance on inpatient hospital admission rates for diabetes short-term complications, including:

  • Diabetic ketoacidosis
  • Hyperosmolarity
  • Coma

The measure is the rate of inpatient hospital admissions per 100,000 beneficiary months for adults age 18 and older.

This measure aligns with the Centers for Disease Control and Prevention’s 6|18 Initiative focus on providing appropriate diabetes care. The 6|18 Initiative focuses on six common and costly health conditions or health behaviors and highlights evidence-based interventions that can prevent or control those conditions. For information on how to drive improvement on this measure, visit: www.cdc.gov/sixeighteen.  

States voluntarily report on PQI 01: Diabetes Short-Term Complications Admissions Rate (PQI01-AD) as part of the Core Set of Adult Health Care Quality Measures. These data show performance rates for states that voluntarily reported the measure using Adult Core Set measure specifications.

The included populations for Adult Core Set measures can vary by state. For example, some states include populations in certain programs, such as beneficiaries covered by Medicaid, but exclude beneficiaries in other programs, such as those dually eligible for Medicare and Medicaid. In addition, states may include beneficiaries in some delivery systems, but exclude other delivery systems. For example, a state may include beneficiaries who are enrolled in managed care, but exclude beneficiaries who are covered on a fee-for-service (FFS) basis. This variation in populations can affect measure performance and comparisons.

Source: Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports for the Adult Core Set Federal Fiscal Year (FFY) 2020 reporting cycle as of June 18, 2021; see 2020 Child and Adult Health Care Quality Measures. PQI stands for prevention quality indicators, a set of measures maintained by the Agency for Healthcare Research and Quality (AHRQ). For more information on the PQI 01: Diabetes Short-Term Complications Admissions Rate (PQI01-AD) measure, visit Adult Health Care Quality Measures.


The term “states” includes the 50 states, the District of Columbia, and Puerto Rico. The following states did not report data to the Centers for Medicare & Medicaid Services (CMS) for this measure: AK, CO, DC, FL, ID, KY, ME, MS, MT, NE, OH, RI, SD, UT, VA, and WI.

The Adult Core Set specifications include guidance for calculating this measure using the administrative method. Unless otherwise specified, the administrative data source is the state’s Medicaid Management Information System (MMIS) and/or data submitted by managed care plans, including behavioral health plans.

Unless otherwise specified:

  • States used Adult Core Set specifications, based on AHRQ 2020 specifications.
  • Denominators are assumed to be the measure-eligible population for states using the administrative method. Some states reported exclusions from the denominator, as noted in the state-specific comments.
  • The measurement period for this measure was January 2019 to December 2019. AZ reported data for FFY 2019.
  • Rates displayed reflect state reporting for Medicaid enrollees ages 18 to 64 (34 states) or age 18 and older (2 states).

ACO = Accountable Care Organization; AHRQ = Agency for Healthcare Research and Quality; CCO = Coordinated Care Organization; CHIP = Children’s Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CMO = Care Management Organization; CY = Calendar Year; ED = Emergency Department; EHR = Electronic Health Record; EQRO = External Quality Review Organization; FFS = Fee for Service; FFY = Federal Fiscal Year; HCBS = Home- and Community-Based Services; HEDIS = Healthcare Effectiveness Data and Information Set; HMO = Health Maintenance Organization; ICD = International Classification of Diseases; LOINC = Logical Observation Identifiers Names and Codes; MACPro = Medicaid and CHIP Program System; MCO = Managed Care Organization; MMIS = Medicaid Management Information System; NCQA = National Committee for Quality Assurance; NR = Not Reported; PCCM = Primary Care Case Management; PCP = Primary Care Practitioner.