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.
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.
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DOI：
10.3390/jcm11061471
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发表时间：
2022-03-08
影响因子：
3.9
通讯作者：
Allen S
中科院分区：
文献类型：
--
作者：
Rubin DJ;Gogineni P;Deak A;Vaz C;Watts S;Recco D;Dillard F;Wu J;Karunakaran A;Kondamuri N;Zhao H;Naylor MD;Golden SH;Allen S
出院30天内再入院（30天再入院）是一项高度优先的质量措施和成本目标。本研究的目的是探讨糖尿病医院护理过渡（DiaTOHC）计划对高危成人糖尿病患者再入院风险的可行性和有效性。这是一项非盲性试点随机对照试验（RCT），比较了安全网医院的常规护理（UC）和DiaTOHC。主要结局是30天全因再入院。在2017年10月16日至2019年5月30日期间，93名患者被随机分组。在意向治疗（ITT）人群中，45例DiaTOHC患者中有14例（31.1%）和46例UC患者中有15例（32.6%）30天再入院，而35.6% DiaTOHC和39.1% UC患者30天再入院或ED就诊。干预- uc成本比为0.33 (0.13-0.79)95%CI。至少93%的受试者对关键干预成分感到满意。在69例基线HbA1c为7.0% （53 mmol/mol）的患者中，30天再入院率分别为23.5% （DiaTOHC）和31.4% (UC)， 30天再入院/ED复诊率分别为26.5% （DiaTOHC）和40.0% （UC）。在该亚组中，干预- uc成本比为0.21 (0.08-0.58)95%CI。DiaTOHC计划可能是可行的，并且可以降低HbA1c水平为bb0.7.0% （53 mmol/mol）的患者的30天再入院/急诊科就诊风险和医疗费用。
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).
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影响因子：
4.2
作者：
Rubin, Daniel J.;Recco, Dominic;Golden, Sherita Hill
通讯作者：
Golden, Sherita Hill
影响因子：
4.2
作者：
Rubin, Daniel J.
通讯作者：
Rubin, Daniel J.
影响因子：
4.2
作者：
Gianchandani, Roma Y.;Pasquel, Francisco J.;Umpierrez, Guillermo E.
通讯作者：
Umpierrez, Guillermo E.
影响因子：
4.2
作者：
Rubin DJ;Shah AA
通讯作者：
Shah AA
影响因子：
16.2
作者：
Umpierrez, Guillermo E.;Reyes, David;Fonseca, Vivian
通讯作者：
Fonseca, Vivian