Introduction: DM is associated with a higher risk of readmissions. We examined the effects of a structured diabetes outpatient program on RR.
Methods: Patients hospitalized with a primary or secondary diagnosis of DM were randomized to standard care (control group [C]) or a structured diabetes program (intervention group [I]) upon discharge. The structured program included a visit to the CDE nurse practitioner (NP) who developed individualized plan for every subject. Subsequent visits were with an NP, nutritionist, social worker and endocrinologist as needed. RR data were generated from electronic medical records and included emergency department (ED) as well as hospital admissions. RR were calculated by dividing the number of readmissions by the number of initial (index) admissions and expressed as %.
Results: 192 subjects were recruited (95 into [C] and 97 into [I]). The mean age was 56±13 yrs [C] and 60±12 yrs [I]. The [C] had 56 (29%) males and 39 (20%) females; [I] had 60 (31%) males and 37 (19%) females. 66 (35%) subjects were African American, 2 (1%) American Indian, 1 (0.5%) Hawaiian, 57 (30%) Caucasian, 11 (5%) Asian, 12 (6%) identified as more than one race, 43 (22%) of unknown race. There were no statistically significant differences between the groups in these characteristics. The 30-day RR: overall (ED and Hospital): 19% [C] and 7% [I], p=0.01; Hospital: 9% [C] and 4% [I], p=0.14; ED: 17% [C] and 4% [I], p=0.003. The 365-day RR: overall 38% [C] and 14% [I], p=0.0002; Hospital: 33% [C] and 8% [I], p<0.001; ED: 34% [C] and 11% [I], p=0.0002.
Conclusion: A structured outpatient diabetes program reduced RR in DM patients when compared with standard care. 30 day RR were reduced primarily due to a reduction in the ED visits, whereas 365 day RR were reduced due the reduction in both ED visits and hospital admissions. Larger multicenter studies are needed to confirm these data.
A. Bhalodkar: None. H. Sonmez: None. M. Lesser: None. T. Leung: None. K. Ziskovich: None. D. Inlall: None. L. Poretsky: None. M. Krymskaya: None. R. Murray-Bachmann: None.