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Research Objectives
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.
Design
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.
Design
“DETC” and “None” two groups, not randomized.
Setting
A public hospital specialized in medical rehabilitation.
Participants
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).
Interventions
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.
Results
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).
Conclusions
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.
Author(s) Disclosures
No conflict of interest for the three authors.
Keywords
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© 2022 Published by Elsevier Inc.
