Lengthier Hospital Stays Linked To Poor Blood Sugar Control
Abnormal blood sugar levels are associated with diabetes patients who had longer, more costly hospital stays than those with healthy glucose levels, studies from Scripps Whittier Diabetes Institute conclude.
More and more patients are now being admitted into U.S. hospitals with diabetes. A recent UCLA public health report pointed out that one of every three hospital patients admitted in California has a diagnosis of diabetes.
On the other hand, changing health care payment models are raising the pressure for health systems to reduce costs at the same time as they are improving patient outcomes.
Co-author and endocrinologist Athena Philis-Tsimikas, M.D., said:
“Data from the new studies suggest poorly controlled blood sugar readings could serve as a marker for better managing the care of patients with diabetes both during their hospital stays and after they have been discharged.
Our research supports having more caregivers in the hospital and clinic settings who are focused on identifying these patients and working to make sure their diabetes is properly managed.”
Multidisciplinary Diabetes Care Teams
One investigated diabetes patients receiving care at two San Diego county Scripps Coastal Medical Center clinics. At one clinic, 236 patients received conventional support, in addition to care from a multidisciplinary team that included a nurse care manager, a nurse focused on managing patient depression and a health coach. At the other clinic, another 238 patients served as a comparison group, receiving only conventional support during the same period.
Over 12 months, the percentage of all intervention group patients with good control of glycated hemoglobin (HbA1c), which is a risk indicator for developing diabetes-related conditions, increased significantly from 75.8 to 91.8. The percentage of patients in the comparison group with good control of HbA1c rose only a slight amount, from 77.3 to 79.2.
Another of the studies used data for 9,995 patients with diabetes admitted to all Scripps Health hospitals in San Diego county between 2012 and 2013 who underwent blood sugar monitoring during their stays.
After controlling for age and gender, patients with poor glucose control, meaning one or more readings exceeding 400 mg/dL, had significantly longer hospital stays averaging 8.50 days than those with good glucose control, meaning readings ranging between 70 and 199 mg/dL, who had stays averaging 5.74 days.
Complete hospitalization costs for patients with poor glucose control averaged $16,382, while costs for patients with good blood sugar control averaged $13,896.
“We don’t have enough physicians who can care for every patient for the amount of time required,” Philis-Tsimikas said. “Surrounding doctors with a specialized care team lets them provide more effective care to patients with diabetes, operate more efficiently and deliver improved outcomes.”