PSUN246 Pilot Study: Impact of discharge follow up care at endocrine clinic on glycemic control and re-admission rate in a community hospital

Abstract

Abstract Introduction The burden of diabetes among hospitalized patients is growing and 30-day readmission rates for those with DM are reported to be 5.9 to 9.2% higher than the rate for all hospitalized patients. We offered follow-up care at a community hospital-based endocrine clinic within 30 days after discharge for those with uncontrolled DM and analyzed its impact on glycemic control and 30 days re-admission rate. Methods This is a single-centered, retrospective study of 29 patients with DM who were hospitalized in our community hospital and were offered a follow-up Endocrine clinic appointment. Results We analyzed a total of 29 discharged patients’ chart with predominantly male (65.51%), T2DM (93%), mean age 58.9±15.7 yrs, BMI 31.35±-9.5 kg/m2, 72.4% on insulin therapy, 79.3% with at least one microvascular complication, and 37.9% with at least once macrovascular complication. A1C 3 8% on admission was observed in 27 patients (93.1%). Although all patients were offered a follow-up appointment, only 23 patients (79.3%) showed up for their follow-up appointments (G1) and 6 patients did not show up (G2).In G1, 4 out of 16 patients (25%) who were on insulin therapy were able to discontinue insulin therapy after endocrine clinic follow-up appointments.In G1, 15 patients (65.21%) achieved A1C < 8% at 3 months. In G1, mean A1C on admission was 11.8 ± 2.8% and improved to 7.7±2.5% whereas mean A1C remained the same for G2. (P= 0.6)The 30 days readmission rate was 21.73% in G1 although reasons for readmission were not directly related to diabetes, whereas no readmission was observed in G2. Conclusion Although our study failed to prove a reduction in 30 days of hospitalization by offering endocrine outpatient care, it has shown improvement in glycemic control. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.