The Diabetes Transition of Hospital Care (DiaTOHC) Pilot Study: A Randomized Controlled Trial of an Intervention Designed to Reduce Readmission Risk of Adults with Diabetes.

Autor: Rubin DJ; Section of Endocrinology, Diabetes, and Metabolism, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA., Gogineni P; Section of Endocrinology, Diabetes, and Metabolism, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA., Deak A; Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA., Vaz C; Section of Endocrinology, Diabetes, and Metabolism, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA., Watts S; Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA., Recco D; Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA., Dillard F; Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA., Wu J; Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA 19140, USA., Karunakaran A; Section of Endocrinology, Diabetes, and Metabolism, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA., Kondamuri N; Section of Endocrinology, Diabetes, and Metabolism, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA., Zhao H; Department of Biomedical Education and Data Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA., Naylor MD; School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA., Golden SH; Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA., Allen S; Section of Endocrinology, Diabetes, and Metabolism, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2022 Mar 08; Vol. 11 (6). Date of Electronic Publication: 2022 Mar 08.
DOI: 10.3390/jcm11061471
Abstrakt: Hospital readmission within 30 days of discharge (30-day readmission) is a high-priority quality measure and cost target. The purpose of this study was to explore the feasibility and efficacy of the Diabetes Transition of Hospital Care (DiaTOHC) Program on readmission risk in high-risk adults with diabetes. This was a non-blinded pilot randomized controlled trial (RCT) that compared usual care (UC) to DiaTOHC at a safety-net hospital. The primary outcome was all-cause 30-day readmission. Between 16 October 2017 and 30 May 2019, 93 patients were randomized. In the intention-to-treat (ITT) population, 14 (31.1%) of 45 DiaTOHC subjects and 15 (32.6%) of 46 UC subjects had a 30-day readmission, while 35.6% DiaTOHC and 39.1% UC subjects had a 30-day readmission or ED visit. The Intervention−UC cost ratio was 0.33 (0.13−0.79) 95%CI. At least 93% of subjects were satisfied with key intervention components. Among the 69 subjects with baseline HbA1c >7.0% (53 mmol/mol), 30-day readmission rates were 23.5% (DiaTOHC) and 31.4% (UC) and composite 30-day readmission/ED visit rates were 26.5% (DiaTOHC) and 40.0% (UC). In this subgroup, the Intervention−UC cost ratio was 0.21 (0.08−0.58) 95%CI. The DiaTOHC Program may be feasible and may decrease combined 30-day readmission/ED visit risk as well as healthcare costs among patients with HbA1c levels >7.0% (53 mmol/mol).
Databáze: MEDLINE
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