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Retrospective study of inpatient diabetes management service, length of stay and 30-day readmission rate of patients with diabetes at a community hospital
| Content Provider | Scilit |
|---|---|
| Author | Mandel, Samantha R. Langan, Susan Mathioudakis, Nestoras Nicolas Sidhaye, Aniket R. Bashura, Holly Bie, Jun Y. Mackay, Periwinkle Tucker, Cynthia Demidowich, Andrew P. Simonds, William F. Jha, Smita Ebenuwa, Ifechukwude Kantsiper, Melinda Howell, Eric E. Wachter, Patricia Golden, Sherita Hill Zilbermint, Mihail |
| Copyright Year | 2019 |
| Description | Background: Hospitalized patients with diabetes are at risk of complications and longer length of stay (LOS). Inpatient Diabetes Management Services (IDMS) are known to be beneficial; however, their impact on patient care measures in community, non-teaching hospitals, is unknown. Objectives: To evaluate whether co-managing patients with diabetes by the IDMS team reduces LOS and 30-day readmission rate (30DR). Methods: This retrospective quality improvement cohort study analyzed LOS and 30DR among patients with diabetes admitted to a community hospital. The IDMS medical team consisted of an endocrinologist, nurse practitioner, and diabetes educator. The comparison group consisted of hospitalized patients with diabetes under standard care of attending physicians (mostly internal medicine-trained hospitalists). The relationship between study groups and outcome variables was assessed using Generalized Estimating Equation models. Results: 4,654 patients with diabetes (70.8 ± 0.2 years old) were admitted between January 2016 and May 2017. The IDMS team co-managed 18.3% of patients, mostly with higher severity of illness scores (p < 0.0001). Mean LOS in patients co-managed by the IDMS team decreased by 27%. Median LOS decreased over time in the IDMS group (p = 0.046), while no significant decrease was seen in the comparison group. Mean 30DR in patients co-managed by the IDMS decreased by 10.71%. Median 30DR decreased among patients co-managed by the IDMS (p = 0.048). Conclusions: In a community hospital setting, LOS and 30DR significantly decreased in patients co-managed by a specialized diabetes team. These changes may be translated into considerable cost savings. |
| Related Links | https://www.tandfonline.com/doi/pdf/10.1080/20009666.2019.1593782?needAccess=true https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484466/pdf |
| Ending Page | 73 |
| Page Count | 10 |
| Starting Page | 64 |
| ISSN | 20009666 |
| e-ISSN | 20009666 |
| DOI | 10.1080/20009666.2019.1593782 |
| Journal | Journal of Community Hospital Internal Medicine Perspectives |
| Issue Number | 2 |
| Volume Number | 9 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2019-03-04 |
| Access Restriction | Open |
| Subject Keyword | Primary Health Care Inpatient Diabetes Management Length of Stay Readmissions Cost Savings Diabetes |
| Content Type | Text |
| Resource Type | Article |
| Subject | Internal Medicine |
