ECE2015 Eposter Presentations Diabetes (pathiophysiology & epitemiology) (80 abstracts)
Evaluation of quality indicators in hospital discharge reports in diabetic patients from an Internal Medicine Service: are we doing a good clinical practice?
José M Varela-Aguilar 1, , Rafael Terán-Redondo 1 , Maria Luz Calero-Bernal 1 , Ana Calzada-Valle 1 , Rosa García-Contreras 1 , Estefanía Pereira-Díaz 1 , Fidel Moreno-Verdejo 1 , Francisco Ruiz-Ruiz 1 & Enrique Calderón-Sandubete 1,
1Internal Medicine Service. Virgen del Rocio Hospital, Seville, Spain; 2CIBER de Epidemiología y Salud Pública, Seville, Spain.
Spanish Scientific Societies involved in diabetic patient care produced a consensus document with recommendations and quality indicators for hospital discharge reports (HDR).
Objective: To analyse adequacy of HDR in diabetic patients from an Internal Medicine Service according to these recommendations (Med Clin (Bar) 2012 138 666.e1–666.e10).
Methods: Study based on a programme continuity of care among Primary Care and Internal Medicine Service. We analyse 150 consecutive HDR in diabetic patients from an internal medicine service of a tertiary hospital. HDR were identified by hospital database and five cases were excluded by death. Clinical information was revised according to nine items recommended in document consensus.
Results: Average age 73.5 years, men 47% and women 53%.T2D 96%, 2% T1D, and steroid diabetes 2%. Diabetes de novo was present in five cases (3.4%). Time evolution diabetes was recorded in 27% of HDR and HbA1c only in 17.8%. Renal function (MDRD-4): Normal FGR 26.8%, 18.5% CKD stage 2, stage 3 33.5%, stage 4 15.7%, and stage 5 5.5%; however, FGR only was recorded in 9% HDR. Antidiabetic treatment preadmission was not collected in 36.3%. Where it was present were: monotherapy oral antidiabetic agents (OAA) 26.7%, 8.9% combination OAA, OAA more insulin 9.5%, alone insulin 18.6%. At discharge changes were made in the treatment at 35% but only 23.2% consisted justification at HDR. Changes were: first insulinisation 19.8%, OAA substitution 7.5%, and replacing insulin type 7.7%. The 45% of HDR collected recommendations on diet and exercise, glycaemic control targets in 7.5%, other control cardiovascular risk factors 9.5%, periodicity 13% glycaemic control and medical supervision (within review and assistance level) 11%.
Conclusions: Quality of HDR diabetic patients is low compared with the established recommendations. An improvement program should be introduced to optimise and tailor treatment in diabetic patients at hospital discharge.
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Endocrine Abstracts
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