Diagnosing diabetes and preventing rehospitalizations - The urban diabetes study
Diagnosing diabetes and preventing rehospitalizations - The urban diabetes study
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DOI：
10.1097/01.mlr.0000199639.20342.87
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发表时间：
2006-03-01
期刊：
影响因子：
3
通讯作者：
Webb, DA
中科院分区：
文献类型：
--
作者：
Robbins, JM;Webb, DA
背景：糖尿病患者经常住院，糖尿病住院护理质量备受关注。出院后再住院是一个常见的不良后果经历的patients with diabetes.Objectives：我们评估的频率和危险因素再住院所有费城居民与diabetes.Methods：个人的住院史，确定从出院摘要费城居民年龄25-84谁至少有1糖尿病住院从1994年至2001年。Logistic回归分析用于评估出院后30天内非选择性再住院的预测因素，包括糖尿病诊断记录。结果：在291，752例出院患者中，58，308例（20.0%）在出院后30天内非选择性再住院。在患者首次糖尿病诊断住院后再住院的比例为9.4%;在未记录糖尿病诊断的后续出院后，所有病例中有30.6%发生再住院。在调整年龄、年龄、性别、种族、保险状况、入院类型、严重程度代码、住院时间、出院状态和既往住院次数后，无糖尿病诊断是再次住院的高度显著预测因素。未能在行政出院数据中记录糖尿病诊断可能反映出对正在接受治疗的糖尿病患者的关键需求缺乏关注。治疗其他疾病，而注意患者教育和后续计划的患者与事件糖尿病诊断可能会降低再住院的风险。
Background: Patients with diabetes frequently are hospitalized, and quality of inpatient care for diabetes is of great concern. Rehospitalization after hospital discharge is a frequent adverse outcome experienced by patients with diabetes.Objectives: We assessed the frequency of and risk factors for rehospitalization among all Philadelphia residents with diabetes.Methods: Individual histories of hospitalization were ascertained from hospital discharge summaries for Philadelphia residents ages 25-84 who had at least 1 diabetes hospitalization from 1994 through 2001. Logistic regression was used to assess predictors of nonelective rehospitalization within 30 days of discharge, including recording of diabetes diagnosis.Results: Nonelective rehospitalizations within 30 days of hospital discharge were ascertained for 58,308 (20.0%) of 291,752 discharges. The proportion rehospitalized was 9.4% after a patient's first diabetes diagnosis hospitalization; after later discharges for which a diabetes diagnosis was not recorded, rehospitalizations occurred in 30.6% of all cases. The absence of a diabetes diagnosis was a highly significant predictor of rehospitalization after adjustment for age, year, gender, race/ethnicity, insurance status, admission type, severity code, length of stay, discharge status, and number of previous hospitalizations.Conclusion: Failure to record a diabetes diagnoses in administrative hospital discharge data may reflect lack of attention to the critical needs of patients with diabetes who are being treated for other conditions, whereas the attention to patient education and follow-up planning for patients with incident diabetes diagnoses may reduce the risk of rehospitalization.