Context: Diabetes mellitus (DM) is common among hospitalized patents. An inpatient diabetes management service (IDMS) has been implemented to provide better glycemic control. The impact on length of stay (LOS) and 30-day readmission rates is unknown.
Objective: We retrospectively analyzed LOS and 30-day readmission rate of patients with known DM admitted to a 240-bed community hospital in suburban Maryland between January 2016 and May 2017.
Methods: International Classification of Diseases 10 codes were used to identify patients with diabetes. LOS and 30-day readmissions were analyzed using Quality Advisor (SM) software. Data were compared by two-sample t-test and simple linear regression analysis.
Results: 4654 patients with DM (71.32±13.95 years, 48.3% female) were admitted to a community hospital during the data collection period. IDMS team was consulted on 22.3% of the patients, while the remainder of patients with DM were cared for by other medical and surgical teams. Average LOS and 30-day-readmission rate in all patients decreased by 0.87 days and 10.52%, respectively, from January 2016 to May 2017. Average LOS of patients cared by IDMS team was higher, than control group (6.49 vs 4.72 days, P=0.000000035). There was no difference in 30-day readmission rates between the groups. Similarly, there was no difference in LOS trends between the two groups (P=0.88).
Conclusions: Since the implementation of IDMS team, LOS and 30-day readmission rate significantly decreased in all patients with diabetes at the community hospital. We speculate that patients with diabetes cared for by the IDMS team may have overall longer LOS, likely due to higher complexity and severity of illness. Limitation of this study includes confounding variables (e.g. mortality index), and a short time frame during which this study was conducted. Further studies are needed, including a formal cost effectiveness analysis, to better assess the economic impact of the IDMS team model in community hospitals.
19 May 2018 - 22 May 2018