Introduction: Hospital readmissions are more common in persons admitted with diabetes as a primary diagnosis, accounting for approximately 20% of unplanned readmissions.1 Poor clinical outcomes and higher costs result.2 Helping people remain out of the hospital with improved diabetes self-management is both patient-centered and cost effective.1 Remote patient care improves access to care, removes transportation as a barrier and lessens the time required versus in person diabetes visits.3
Methods: The glucose management team (GMT) at Atrium Health Wake Forest Baptist Medical Center, comprised of advanced practice providers and an endocrinologist, offered post-discharge telehealth visits within 7 days to patients with insulin treated complex diabetes from 1/1 - 3/24/21. Patients’ diabetes regimens and glucose readings were reviewed and recommendations for treatment changes were offered.
Results: A total of 88 patients were scheduled for post-discharge visits, and 55.7% (n=49) participated in a scheduled telehealth visit, while 36.4% did not (n=32) . Of patients who no-showed, there were zero 30 day readmissions and fourteen 90 day readmissions (43.8%) . Of patients who had a telehealth visit, there were two 30 day readmissions (4%) and eleven 90 day readmissions (22.4%) . Odds ratio for 90 day readmission was 2.69 (p=0.042) in those who did not attend a post-discharge telehealth visit.
Conclusion: While 30-day readmissions were higher in the group that had a telehealth visit, this may be due to global struggles with nonadherence in the no-show group. An odds ratio of over 2.5 for 90 day readmission compared to patients who completed a post-discharge telehealth visit supports this view. Post-discharge telehealth visits decreased unplanned readmissions at 90 days by providing access to expert clinicians for support, instruction on self-directed glucose management and treatment regimen recommendations.
A.Johns: None. C.E.Price: None. J.A.Aloi: Research Support; Abbott Diabetes, Medtronic. C.Burns: None.
