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To investigate if attending the Diabetes Education Transition Class (DETC) related to fewer readmissions compared to those who declined the DETC during the patients' hospitalization to a limb preservation service.
A retrospective quality improvement study was conducted to review the electronic medical records of a cohort of patients with diabetes when hospitalized for pending non-traumatic lower extremity amputations, 1/1/2018 – 6/30/2019. Tracking patients’ readmissions at least 3-month post-discharge was included. Patients frequently declined to attend the DETC; it created a “pseudo” case-control study.
“DETC” and “None” two groups, not randomized.
A public hospital specialized in medical rehabilitation.
The study included 127 in the DETC and 106 in the None groups. The mean ages were comparable, 54.3 and 55.4 for the DETC and None, respectively. The A1c of the DETC was found to be significantly higher than that of the None group (10.0 vs. 9.3; p <.034).
The DETC was about one hour, focusing on target blood glucose goals, blood glucose monitoring, insulin preparation and administration, signs/symptoms of hyperglycemia/hypoglycemia - treatment and prevention, skin and foot care, and access to resources.
Main Outcome Measures
The number of patients being readmitted to emergency or hospitalized during the 1-month, 2-month, and 3-month post-discharge durations.
Using the Chi-square statistics testing for independence (df:1), the readmissions were compared between the two groups during the post-discharged three periods with one-tailed p-values. In the 1-month post-discharge, 2 from the DETC and 9 from the None were readmitted (Chi: 6.143; p: 0.013). Within the 2-month post-discharge, the readmission appeared to be increased with 5 in the DETC and 19 in the None groups (Chi: 12.234; p: 0.00047). The re-admissions that took place during the 3-month post-discharge were 10 in the DETC and 28 in the None groups (Chi: 14.552; p: 0.00014).
The DETC seems to be associated with fewer readmissions. The interpretation of the results should consider the reasons why patients refused to attend the DETC.
No conflict of interest for the three authors.
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