Link Between Diabetes and Hospital Readmission Rates
Patients who received diabetes services had lower rates of ED and observation readmissions, but not inpatient readmissions.
Patients with diabetes have higher rates of hospital readmission compared with patients without diabetes, according to a pilot study published in Clinical Diabetes and Endocrinology.
Researchers from the University of Michigan in Ann Arbor conducted 2 studies using different datasets. The first was a retrospective review of all patients admitted (n=7763) to any adult service within the University of Michigan Health System with a principal or secondary admission diagnosis of diabetes followed by an uncontrolled analysis of patients with a principal admission diagnosis of diabetes. The second analysis was a larger retrospective study (n=37,702) of all adults discharged from the University of Michigan Health System with a principal or secondary discharge diagnosis of diabetes.
In the first study, the readmission rate was 26% in patients with diabetes vs 22% in patients without diabetes. The most common cause for readmission was diabetes-related in patients with a principal diagnosis of diabetes on index admission, whereas the most common cause for readmission in patients with a secondary diagnosis of diabetes was infection-related.
Of the patients with diabetes, approximately only 12% received any type of diabetes service consult (eg, Hyperglycemic Intensive Insulin Program [HIIP] or Endocrine Consults [ENDO]). Patients who received diabetes services had lower rates of emergency department and observation readmissions (6.6% HIIP or ENDO vs 9.6% no HIIP or ENDO; P =.0012), although there were no differences in the inpatient readmission rates (17.6% HIIP or ENDO vs 17.4% no HIIP or ENDO; P =.89).
"[Diabetes] services were utilized in a very small population of patients with [diabetes] and may have contributed to lower [emergency department] revisits by providing more robust diabetes management, discharge planning and instruction," the researchers wrote. "Their impact on readmission in prospective studies needs to be evaluated."
- The study was retrospective in nature; patient data were derived from data warehouse and chart review.
- Patients who had known diabetes, but did not have a "billing diagnosis" of diabetes, were not included, and therefore, not all patients with diabetes may have been captured.
- The 2 diabetes consult groups, HIIP and ENDO, service different patient populations.
- These data were collected from 1 academic institution and may not be generalizable to patients elsewhere.