Background: The high prevalence of diabetes makes it a common co-morbid condition in hospitalized patients. Healthcare systems have increasingly focused on 30-day readmission rates to improve quality and reduce costs. Readmission rates for patients with diabetes are much higher than the rate for all hospitalized patients. In a recent retrospective analysis, formal diabetes education by a certified diabetes educator reduced 30-day readmissions. Unfortunately, many institutions don’t have the resources to provide this service to all patients with diabetes. Our institution implemented a pilot program to see whether patients provided with brief, one-time, inpatient diabetes self-management support by a care manager would reduce 30-day hospital readmission rates.
Methods: We conducted a retrospective analysis of patients who participated in the pilot program. On one day per week, between 3/1 and 6/1/2017, hospitalized eligible patients received diabetes self-management support by a care manager (SUPPORT). Eligible patients identified on another day of the week did not receive the intervention and served as the CONTROL group. Data were collected retrospectively by record review. 30-day readmission rates were compared and analyzed with a chi-square test.
Results: We reviewed the records of 298 patients. The average age was 62. 3, average HbA1C was 12. 6 and 49. 5 % were female. Overall, there was no significant difference in 30-day readmission rate in SUPPORT versus CONTROL patients.
Conclusions: Brief inpatient diabetes self-management support for patients in this study was not effective in reducing 30-day hospital re-admission rates. In the very small subgroup of patients with a diabetes-related admission diagnosis (e. g., diabetic ketoacidosis, hyperglycemic hyperosmolar syndrome, and hypoglycemia) there was a hint that readmissions may be lower in the SUPPORT vs. CONTROL patients (12. 5 vs. 16. 67%, p =1. 0). Further investigation of this subgroup may be warranted.
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