Hospital readmission is an important contributor to total medical expenditures and is an emerging indicator of quality of care. Diabetes, similar to other chronic medical conditions, is associated with increased risk of hospital readmission. Risk factors include previous hospitalization, extremes in age, and socioeconomic barriers. Preliminary studies suggest that acute and/or chronic glycemic control may be of importance when diabetes is the primary diagnosis or when it is a comorbidity. Very limited evidence from prospective randomized controlled trials aimed at improving glycemic control is available. However, whether one concludes that inpatient or outpatient glycemic control is partly responsible for reduced hospitalizations, attention to glycemic control in the hospital may facilitate sustained glycemic control post-discharge. Limited prospective and retrospective evidence suggest that the involvement of a diabetes specialist team may improve readmission rates, but attention to more generalized comprehensive approaches may also be worthwhile. Prospective interventional studies targeting interventions for improving glycemic control are needed to determine whether glycemic control impacts readmission rates.
CalverJBrameldKJPreenDBAlexiaSJBoldyDPMcCaulKA.High-cost users of hospital beds in Western Australia: a population-based record linkage study. Med J Aust. 2006; 184 (8): 393–7.
2.
JohansenHNairCBondJ.Who goes to the hospital? An investigation of high users of hospital days. Health Rep. 1994; 6 (2): 253–77.
3.
ZookCJMooreFD.High-cost users of medical care. N Engl J Med. 1980; 302 (18): 996–1002.
4.
JencksSFWilliamsMVColemanEA.Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009; 360 (14): 1418–28.
5.
EpsteinAM.Revisiting readmissions—changing the incentives for shared accountability. N Engl J Med. 2009; 360 (14): 1457–9.
6.
Rumball-SmithJHiderP.The validity of readmission rate as a marker of the quality of hospital care, and a recommendation for its definition. N Z Med J. 2009; 122 (1289): 63–70.
7.
BillingsJDixonJMijanovichTWennbergD.Case finding for patients at risk of readmission to hospital: development of algorithm to identify high risk patients. BMJ. 2006; 333 (7563): 327.
8.
HowellSCooryMMartinJDuckettS.Using routine inpatient data to identify patients at risk of hospital readmission. BMC Health Serv Res. 2009; 9: 96.
9.
ShiptonS.Risk factors associated with multiple hospital readmissions. Home Care Provid. 1996; 1 (2): 83–5.
10.
JacobLPoletickEB.Systematic review: predictors of successful transition to community-based care for adults with chronic care needs. Care Manag J. 2008; 9 (4): 154–65.
11.
American Diabetes Association. Economic costs of diabetes in the U.S.. in 2007. Diabetes Care. 2008; 31 (3): 596–615.
12.
KropJSPoweNRWellerWEShafferTJSaudekCDAndersonGF.Patterns of expenditures and use of services among older adults with diabetes. Implications for the transition to capitated managed care. Diabetes Care. 1998; 21 (5): 747–52.
13.
JiangHJStryerDFriedmanBAndrewsR.Multiple hospitalizations for patients with diabetes. Diabetes Care. 2003; 26 (5): 1421–6.
14.
HosseiniMSNematiEPourfarzianiVTaheriSNourbalaMHEinollahiB.Early hyperglycemia after allogenic kidney transplantation: does it induce infections. Ann Transplant. 2007; 12 (4): 23–6.
15.
NyenweELoganathanRBlumSEzutehDEraniDPalaceMOguguaC.Admissions for diabetic ketoacidosis in ethnic minority groups in a city hospital. Metabolism. 2007; 56 (2): 172–8.
16.
IsidroMLJorgeS.Recreational drug abuse in patients hospitalized for diabetic ketosis or diabetic ketoacidosis. Acta Diabetol. 2010. Epub ahead of print.
17.
KovacsMCharron-ProchownikDObroskyDS.A longitudinal study of biomedical and psychosocial predictors of multiple hospitalizations among young people with insulin-dependent diabetes mellitus. Diabet Med. 1995; 12 (2): 142–8.
18.
JiangHJAndrewsRStryerDFriedmanB.Racial/ethnic disparities in potentially preventable readmissions: the case of diabetes. Am J Public Health. 2005; 95 (9): 1561–7.
Pérez-BarqueroM MonteroFernándezR Martínezde Los Mártires AlmingolIDoñaA MichánGutiérrezP Conthe; DICAMI Study. Prognostic factors in patients admitted with type 2 diabetes in Internal Medicine Services: hospital mortality and readmission in one year (DICAMI study). Rev Clin Esp. 2007; 207 (7): 322–30.
21.
KrumholzHMChenYTWangYVaccarinoVRadfordMJHorwitzRI.Predictors of readmission among elderly survivors of admission with heart failure. Am Heart J. 2000; 139 (1 Pt 1): 72–7.
22.
GreenbergBHAbrahamWTAlbertNMChiswellKClareRStoughWGGheorghiadeMO'ConnorCMSunJLYancyCWYoungJBFonarowGC.Influence of diabetes on characteristics and outcomes in patients hospitalized with heart failure: a report from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF). Am Heart J. 2007; 154 (2): 277.e1–8.
23.
RamezaniMGhoddousiKHashemiMKhoddami-VishteHRFatemi-ZadehSSaadatSHKhedmatHNaderiM.Diabetes as the cause of end-stage renal disease affects the pattern of post kidney transplant rehospitalizations. Transplant Proc. 2007; 39 (4): 966–9.
24.
D'AgostinoRSJacobsonJClarksonMSvenssonLGWilliamsonCShahianDM.Readmission after cardiac operations: prevalence, patterns, and predisposing factors. J Thorac Cardiovasc Surg. 1999; 118 (5): 823–32.
25.
SteuerJBlomqvistPGranathFRydhBEkbomAde FaireUStåhleE.Hospital readmission after coronary artery bypass grafting: are women doing worse?Ann Thorac Surg. 2002; 73 (5): 1380–6.
26.
FerrarisVAFerrarisSPHarmonRCEvansBD.Risk factors for early hospital readmission after cardiac operations. J Thorac Cardiovasc Surg. 2001; 122 (2): 278–86.
27.
WhangWBiggerJTJr. Diabetes and outcomes of coronary artery bypass graft surgery in patients with severe left ventricular dysfunction: results from the CABG Patch Trial database. The CABG Patch Trial Investigators and Coordinators. J Am Coll Cardiol. 2000; 36 (4): 1166–72.
28.
MenzinJKornJRCohenJLoboFZhangBFriedmanMNeumannPJ.Relationship between glycemic control and diabetes-related hospital costs in patients with type 1 or type 2 diabetes mellitus. J Manag Care Pharm. 2010; 16 (4): 264–75.
29.
Von BibraHHansenADounisVBystedtTMalmbergKRydénL.Augmented metabolic control improves myocardial diastolic function and perfusion in patients with non-insulin dependent diabetes. Heart. 2004; 90 (12): 1483–4.
30.
TurinaMFryDEPolkHCJr. Acute hyperglycemia and the innate immune system: clinical, cellular, and molecular aspects. Crit Care Med. 2005; 33 (7): 1624–33.
31.
MistiaenPPootE.Telephone follow-up, initiated by a hospital-based health professional, for postdischarge problems in patients discharged from hospital to home. Cochrane Database Syst Rev. 2006;(4):CD004510.
32.
KimmelBSullivanMMRushakoffRJ.Survey on transition from inpatient to outpatient for patients on insulin: what really goes on at home?Endocr Pract. 2010; 16 (5): 785–91.
33.
DunganKMOseiKNagarajaHNSchusterDPBinkleyP.Relationship between glycemic control and readmission rates in patients hospitalized with congestive heart failure during implementation of hospital-wide initiatives. Endocr Pract. 2010; 16 (6): 945–51.
34.
AnejaATangWHBansilalSGarciaMJFarkouhME.Diabetic cardiomyopathy: insights into pathogenesis, diagnostic challenges, and therapeutic options. Am J Med. 2008; 121 (9): 748–57.
35.
RamosMKhalpeyZLipsitzSSteinbergJPanizalesMTZinnerMRogersSO.Relationship of perioperative hyperglycemia and postoperative infections in patients who undergo general and vascular surgery. Ann Surg. 2008; 248 (4): 585–91.
36.
FurnaryAPWuYBookinSO.Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocr Pract. 2004; 10Suppl 2: 21–33.
37.
GodarDAKumarDRSchmelzerKMTalsnessSRLiangHSchmelzerJRMazzaJJYaleSH.The impact of serum glucose on clinical outcomes in patients hospitalized with community-acquired pneumonia. WMJ. 2011; 110 (1): 14–20.
38.
EurichDTGambleJMMarrieTJMajumdarSR.Dysglycaemia and 90 day and 1 year risks of death or readmission in patients hospitalised for community-acquired pneumonia. Diabetologia. 2010; 53 (3): 497–503.
39.
DudasVBookwalterTKerrKMPantilatSZ.The impact of followup telephone calls to patients after hospitalization. Am J Med. 2001; 111 (9B): 26S–30S.
40.
WheelerKCrawfordRMcAdamsDBenelSDunbarVGCaudleJMGeorgeCEl-KebbiIGallinaDLZiemerDCCookCB.Inpatient to outpatient transfer of care in urban patients with diabetes: patterns and determinants of immediate postdischarge follow-up. Arch Intern Med. 2004; 164 (4): 447–53.
41.
WheelerKCrawfordRMcAdamsDRobinsonRDunbarVGCookCB.Inpatient to outpatient transfer of diabetes care: perceptions of barriers to postdischarge followup in urban African American patients. Ethn Dis. 2007; 17 (2): 238–43.
42.
ShepperdSMcClaranJPhillipsCOLanninNAClemsonLMMcCluskeyACameronIDBarrasSL.Discharge planning from hospital to home. Cochrane Database Syst Rev. 2010;(1):CD000313.
43.
JackBWChettyVKAnthonyDGreenwaldJLSanchezGMJohnsonAEForsytheSRO'DonnellJKPaasche-OrlowMKManassehCMartinSCulpepperL.A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med. 2009; 150 (3): 178–87.
44.
DedhiaPKravetSBulgerJHinsonTSridharanAKolodnerKWrightSHowellE.A quality improvement intervention to facilitate the transition of older adults from three hospitals back to their homes. J Am Geriatr Soc. 2009; 57 (9): 1540–6.
45.
UmpierrezGESmileyDZismanAPrietoLMPalacioACeronMPuigAMejiaR.Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes (RABBIT 2 trial). Diabetes Care. 2007; 30 (9): 2181–6.
46.
UmpierrezGEHorTSmileyDTemponiAUmpierrezDCeronMMunozCNewtonCPengLBaldwinD.Comparison of inpatient insulin regimens with detemir plus aspart versus neutral protamine Hagedorn plus regular in medical patients with type 2 diabetes. J Clin Endocrinol Metab. 2009; 94 (2): 564–9.
47.
MoghissiESKorytkowskiMTDiNardoMEinhornDHellmanRHirschIBInzucchiSEIsmail-BeigiFKirkmanMSUmpierrezGE; American Association of Clinical Endocrinologists; American Diabetes Association. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009; 32 (6): 1119–31.
48.
LipskaKJWangYKosiborodMMasoudiFAHavranekEPKrumholzHMInzucchiSE.Discontinuation of antihyperglycemic therapy and clinical outcomes after acute myocardial infarction in older patients with diabetes. Circ Cardiovasc Qual Outcomes. 2010; 3 (3): 236–42.
49.
RobbinsJMWebbDA.Diagnosing diabetes and preventing rehospitalizations: the urban diabetes study. Med Care. 2006; 44 (3): 292–6.
50.
AroraVMManjarrezEDresslerDDBasaviahPHalasyamaniLKripalaniS.Hospitalist handoffs: a systematic review and task force recommendations. J Hosp Med. 2009; 4 (7): 433–40.
51.
KoproskiJPrettoZPoretskyL.Effects of an intervention by a diabetes team in hospitalized patients with diabetes. Diabetes Care. 1997; 20 (10): 1553–5.
52.
DaviesMDixonSCurrieCJDavisREPetersJR.Evaluation of a hospital diabetes specialist nursing service: a randomized controlled trial. Diabet Med. 2001; 18 (4): 301–7.
53.
CookCBSeifertKMHullBPHovanMJCharlesJCMiller-CageVBoyleMEHarrisJKMagallanezJMLittmanSD.Inpatient to outpatient transfer of diabetes care: planing for an effective hospital discharge. Endocr Pract. 2009; 15 (3): 263–9.
54.
PietteJDWeinbergerMKraemerFBMcPheeSJ.Impact of automated calls with nurse follow-up on diabetes treatment outcomes in a department of Veterans Affairs Health Care System: a randomized controlled trial. Diabetes Care. 2001; 24 (2): 202–8.
55.
KimHSOhJA.Adherence to diabetes control recommendations: impact of nurse telephone calls. J Adv Nurs. 2003; 44 (3): 256–61.
56.
PietteJDWeinbergerMMcPheeSJMahCAKraemerFBCrapoLM.Do automated calls with nurse follow-up improve self-care and glycemic control among vulnerable patients with diabetes?Am J Med. 2000; 108 (1): 20–7.
57.
JovicicAHolroyd-LeducJMStrausSE.Effects of self-management intervention on health outcomes of patients with heart failure: a systematic review of randomized controlled trials. BMC Cardiovasc Disord. 2006; 6: 43.
58.
LermanIDíazJ PIbarguengoitiaMEPérezFJVillaARVelascoMLCruzRGRodrigoJA.Nonadherence to insulin therapy in low-income, type 2 diabetic patients. Endocr Pract. 2009; 15 (1): 41–6.
59.
MaldonadoMRD'AmicoSRodriguezLIyerDBalasubramanyamA.Improved outcomes in indigent patients with ketosis-prone diabetes: effect of a dedicated diabetes treatment unit. Endocr Pract. 2003; 9 (1): 26–32.
