Real-time support of pediatric diabetes self-care by a transport team.
Real-time support of pediatric diabetes self-care by a transport team.
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DOI：
10.2337/dc13-1041
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发表时间：
2014
期刊：
影响因子：
16.2
通讯作者：
Ferry RJ Jr
中科院分区：
文献类型：
--
作者：
Franklin BE;Crisler SC Jr;Shappley R;Armour MM;McCommon DT;Ferry RJ Jr
该研究旨在通过Pedi-Flite（一个重症监护运输团队）的新整合来改善服务不足的患者的可及性，并验证这是否安全地增强了糖尿病护理并有效地扩大了内分泌劳动力。该研究回顾性分析了Pedi-Flite支持开始后，一组已确诊的糖尿病患者（n = 979）的寻呼机服务使用情况。结果包括复发性糖尿病酮症酸中毒（DKA）的发生率和严重程度，以及减少转诊至急诊科（艾德）和随叫随到内分泌科医生所节省的费用。我们生成描述性统计量来描述研究人群和DKA的艾德访视，并构建逻辑回归模型来检查寻呼机使用与艾德访视和DKA的艾德非选择性住院的可能性之间的关系。寻呼机用户占患者人群的30%。他们更年轻，但比非使用者有更多的糖尿病。使用寻呼机者因DKA而到艾德急诊室就诊的可能性是不使用寻呼机者的2.75倍（P < 0.0001），但他们的就诊不太可能导致住院（优势比0.58; P < 0.02）。超过一半（n = 587）的呼叫寻呼机解决，无需进一步转诊。据估计，避免了439次艾德就诊和115次入院，潜在的成本节省超过760，000美元。运输服务的整合提供了一种新颖的，具有成本效益的方法，以减少糖尿病护理的差异。优点包括可扩展性，适用于其他疾病领域和环境，以及低附加成本。这些发现丰富了一个新兴的证据基础，由专职医疗人员支持的电话护理管理模式。
The study seeks to improve access for underserved patients via novel integration of Pedi-Flite (a critical care transport team) and to validate whether this safely enhances diabetes care and effectively expands the endocrine workforce. The study retrospectively analyzed pager service use in a cohort of established diabetic patients (n = 979) after inception of Pedi-Flite support. Outcomes included incidence and severity of recurrent diabetic ketoacidosis (DKA) and cost savings generated from reduced referrals to the emergency department (ED) and on-call endocrinologist. We generated descriptive statistics to characterize the study population and ED visits for DKA and constructed logistic regression models to examine associations of pager use and likelihood of ED visitation and nonelective inpatient admission from an ED for DKA. Pager users comprised 30% of the patient population. They were younger but had more established diabetes than nonusers. While pager users were 2.75 times more likely than nonusers to visit the ED for DKA (P < 0.0001), their visits were less likely to lead to inpatient admissions (odds ratio 0.58; P < 0.02). More than half (n = 587) of all calls to the pager were resolved without need for further referral. Estimates suggest that 439 ED visits and 115 admissions were avoided at a potential cost savings exceeding 760,000 USD. Integration of a transport service provides a novel, cost-effective approach to reduce disparities in diabetes care. Advantages include scalability, applicability to other disease areas and settings, and low added costs. These findings enrich an emerging evidence base for telephonic care-management models supported by allied health personnel.
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影响因子：
5.1
作者：
Lee, Joyce M.;Davis, Matthew M.;Freed, Gary L.
通讯作者：
Freed, Gary L.
影响因子：
5.1
作者：
Izquierdo, Roberto;Morin, Philip C.;Weinstock, Ruth S.
通讯作者：
Weinstock, Ruth S.
影响因子：
4.2
作者：
Rewers, Arleta
通讯作者：
Rewers, Arleta
DOI：
10.1016/j.pedn.2004.12.010
发表时间：
2005-04-01
期刊：
Journal of pediatric nursing
影响因子：
--
作者：
Howe, Carol J;Jawad, Abbas F;Murphy, Kathryn M
通讯作者：
Murphy, Kathryn M
影响因子：
16.2
作者：
American Diabetes Association
通讯作者：
American Diabetes Association