Inpatient diabetes education is associated with less frequent hospital readmission among patients with poor glycemic control.
Inpatient diabetes education is associated with less frequent hospital readmission among patients with poor glycemic control.
复制标题
住院糖尿病教育与血糖控制差的患者的住院入院率较低有关。
DOI：
10.2337/dc13-0108
复制
发表时间：
2013-10
期刊：
影响因子：
16.2
通讯作者：
Dungan KM
中科院分区：
文献类型：
--
作者：
Healy SJ;Black D;Harris C;Lorenz A;Dungan KM
探讨住院糖尿病教育（IDE）与糖尿病控制不佳患者再入院的关系。回顾性识别2008年至2010年期间住院的出院诊断为糖尿病（ICD-9代码250.x）且HbA 1c>9%的患者。在出院后30天和180天内确定全因首次再入院。IDE由经过认证的糖尿病教育者或培训生进行。采用逐步回归Logistic回归模型分析IDE与再入院的关系。总共有2，265例患者被纳入30天分析，2，069例患者被纳入180天分析。接受IDE的患者在30天内的再入院率低于未接受IDE的患者（11 vs. 16%; P = 0.0001）。在调整社会人口统计学和疾病相关因素后，这种关系仍然存在（比值比0.66 [95%CI 0.51-0.85]; P = 0.001）。在这个模型中，医疗补助保险和更长的停留时间也是独立的预测因素。IDE还与180天内再入院率降低相关，尽管这种关系有所减弱。在最终的180天模型中，没有IDE、非裔美国人种族、医疗补助或医疗保险、住院时间更长和HbA 1c更低与再入院率增加独立相关。进一步的分析确定，只有接受糖尿病教育咨询的患者中，HbA 1c较高与再入院频率较低相关。正式IDE与30天内全因再入院频率较低独立相关;这种关系在180天后减弱。需要前瞻性研究来证实这种关联。
To explore the relationship between inpatient diabetes education (IDE) and hospital readmissions in patients with poorly controlled diabetes. Patients with a discharge diagnosis of diabetes (ICD-9 code 250.x) and HbA1c >9% who were hospitalized between 2008 and 2010 were retrospectively identified. All-cause first readmissions were determined within 30 days and 180 days after discharge. IDE was conducted by a certified diabetes educator or trainee. Relationships between IDE and hospital readmission were analyzed with stepwise backward logistic regression models. In all, 2,265 patients were included in the 30-day analysis and 2,069 patients were included in the 180-day analysis. Patients who received IDE had a lower frequency of readmission within 30 days than did those who did not (11 vs. 16%; P = 0.0001). This relationship persisted after adjustment for sociodemographic and illness-related factors (odds ratio 0.66 [95% CI 0.51–0.85]; P = 0.001). Medicaid insurance and longer stay were also independent predictors in this model. IDE was also associated with reduced readmissions within 180 days, although the relationship was attenuated. In the final 180-day model, no IDE, African American race, Medicaid or Medicare insurance, longer stay, and lower HbA1c were independently associated with increased hospital readmission. Further analysis determined that higher HbA1c was associated with lower frequency of readmission only among patients who received a diabetes education consult. Formal IDE was independently associated with a lower frequency of all-cause hospital readmission within 30 days; this relationship was attenuated by 180 days. Prospective studies are needed to confirm this association.
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影响因子：
2.1
作者：
Jovicic, Aleksandra;Holroyd-Leduc, Jayna M;Straus, Sharon E
通讯作者：
Straus, Sharon E
影响因子：
39.2
作者：
Kaboli, Peter J.;Go, Jorge T.;Vaughan-Sarrazin, Mary
通讯作者：
Vaughan-Sarrazin, Mary
影响因子：
3
作者：
Robbins, JM;Webb, DA
通讯作者：
Webb, DA
影响因子：
16.2
作者：
Jiang, HJ;Stryer, D;Andrews, R
通讯作者：
Andrews, R
影响因子：
2.8
作者：
Howell S;Coory M;Martin J;Duckett S
通讯作者：
Duckett S