Abstract
Is There a Role of Hemoglobin A1C in Predicting Hospital Re-Admission Rates for Patients with Diabetes?
Highlights
Hospital readmission is an indicator of quality of care and plays a significant role in total medical cost
The proportion with HbA1c tests among the 6,592 admissions without readmissions (41.9%) was similar (p=0.18). Among those who had a complete hemoglobin A1C (HbA1C), there was no difference in the average HbA1C values between the group that was readmitted and those that were not ((7.63% vs 7.55%), p = 0.47).The median length of stay (LOS) was higher among the readmitted group (5 vs 4 days) (Table 1)
Obtaining an HbA1C measurement at time of admission may be a useful tool for predicting patients more likely to have more than one readmission
Summary
Hospital readmission is an indicator of quality of care and plays a significant role in total medical cost. A large proportion of hospital costs are attributed to a small percentage of patients with chronic medical conditions who have repeated hospitalizations.[1] As per Jencks et al, approximately 20% of all hospitalized Medicare patients are readmitted within 30 days, and 34% are readmitted within 90 days of discharge.[2] Co-morbid medical conditions that have been associated with readmission included chronic obstructive pulmonary disease (COPD), alcoholism, diabetes mellitus (DM), chronic renal failure, liver disease, anemia, acute coronary syndrome, congestive heart failure (CHF), peripheral vascular disease, and malignancy.[1]. The American Diabetes Association (ADA), in 2017, estimated that the cost of diabetes was $327 billion, with $237 billion of this cost incurred by direct medical costs and $90 billion in reduced productivity.[3] Providing care to a patient with diabetes is estimated to cost approximately 2.3 times that of a patient without diabetes[3], explained by the fact that chronically elevated blood glucose is associated with an increased risk of organ damage. Complications caused by elevated glucose levels include microvasculopathy, nephropathy, Bakeri et al Endocrinol Diab Obese. 2018, 1(2):[3]
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