Hospital readmission and emergency department use based on prescribing patterns in patients with severely uncontrolled type 2 diabetes mellitus
| Autor: | Phillip H Lee, Patrick B. Barlow, Michelle Z. Farland, Andrea S. Franks |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Time Factors Endocrinology Diabetes and Metabolism Type 2 diabetes Hypoglycemia Anxiety Patient Readmission Risk Assessment Endocrinology Cost of Illness Diabetes mellitus medicine Humans Hypoglycemic Agents Practice Patterns Physicians' Intensive care medicine Retrospective Studies Glycated Hemoglobin business.industry Medical record Type 2 Diabetes Mellitus Retrospective cohort study Emergency department Middle Aged medicine.disease United States Medical Laboratory Technology Regimen Cross-Sectional Studies Treatment Outcome Diabetes Mellitus Type 2 Emergency medicine Patient Compliance Female business Emergency Service Hospital Biomarkers |
| Zdroj: | Diabetes technologytherapeutics. 16(3) |
| ISSN: | 1557-8593 |
| Popis: | Patients with uncontrolled diabetes are more likely to be readmitted to the hospital. The study objective was to determine the risk of hospital admission or emergency department (ED) use in patients with severely uncontrolled type 2 diabetes mellitus based on whether their diabetes medication regimen was intensified at discharge.A retrospective cohort study of patients admitted to the medicine services at an academic medical center was conducted during a 9-month period. Medical records were reviewed to identify patients with type 2 diabetes mellitus and hemoglobin A1c10% who were admitted for more than 24 h. Primary exclusion criteria included pregnancy, age65 or18 years, life expectancy of12 months, hypoglycemia at admission, and new diagnosis of type 2 diabetes. Admission medication lists for patients were compared with discharge medications to determine whether the diabetes regimen was intensified. Patients whose regimen was intensified were then compared with patients whose regimen was not intensified for admissions and ED visits within 3 months after discharge. The primary end point was 90-day all-cause hospital and ED visits.Patients who had their regimens intensified had significantly fewer average all-cause hospital and ED visits at 90 days (0.41 vs. 0.85; P=0.044). Statistical differences were also found in 30-day all-cause visits, readmissions within 90 days, and hospital-free time.Patients whose home diabetes regimen was intensified at discharge were less likely to return to the hospital within 90 days compared with patients whose regimen was not intensified. |
| Databáze: | OpenAIRE |
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