Emergency Department Visits for Hypoglycemia in Older Adults With Diabetes (EDH)

Assesses the rate of emergency department (ED) visits for hypoglycemia among Medicare (67 and older) health plan members with type 1 or type 2 diabetes. A separate rate is reported for ED visits for hypoglycemia among eligible members with diabetes who were treated with insulin. As well as reporting observed rates, NCQA also specifies that plans report an expected count of ED visits for hypoglycemia, predicted using members’ prior and current health, among other factors. The observed event count and the expected event count are used to calculate a calibrated observed-to-expected (O/E) ratio that assesses whether plans had more, the same or fewer ED visits for hypoglycemia than predicted by their case mix, while accounting for incremental improvements across all plans over time. An O/E ratio below 1 indicates better-than-average performance and an O/E ratio above 1 worse-than-average performance.

Why It Matters?

Diabetes is a chronic condition characterized by high blood sugar levels due to the body’s inability to make or use insulin. If unmanaged, diabetes can result in low blood sugar (hypoglycemia), which is associated with serious complications such as cardiovascular disease, stroke, falls, fractures, dementia, reduced quality of life, and increased mortality.^1,2 In younger, healthy adults, diabetes management focuses on preventing high blood sugar (hyperglycemia) and its complications through strict blood sugar control and intensive treatment. However, for older adults, avoiding hypoglycemia is equally critical for safe and effective care. Older adults are more likely to experience dangerous adverse events to intensive treatment, most notably hypoglycemia.³ While evidence suggests the risk of hypoglycemia may be reduced through appropriate treatment, older adults continue to experience hypoglycemia, potentially due to overtreatment and intense blood sugar control.⁴ With support from health care providers, older adults can reduce the risk of hypoglycemia and ED visits by monitoring their blood sugar and adjusting treatment targets.⁵

Historical Results – National Averages

Performance results for this measure are currently unavailable. Visit our Quality Compass page to explore data licensing options and gain access to detailed performance results for this measure.