Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

Are we missing a golden opportunity? (#256)

Navira Samad 1 , Jennifer Wong 2 3 , Benjamin Rogers 4
  1. General Medicine / HITH/ Endocrinology, Monash Health, Melbourne, Victoria, Australia
  2. Dept Diabetes and Vascular Medicine , Monash Health, Melbourne, Victoria, Australia
  3. Monash Centre for Health Research and Implementation, Monash University, Melbourne, Victoria, Australia
  4. Infectious Diseases / HITH, Monash Health, Melbourne, Victoria, Australia

BACKGROUND:Hospital in the Home (HITH) provides admitted care to public hospital patients in the comfort of their home and shares a substantial burden of inpatient load. This study was performed to establish the prevalence of diabetes and to characterize the status of diabetes management activity in HITH population at our institution.

OBJECTIVE: 

  1. The prevalence of diabetes in HITH population
  2. The admission indication, the length of stay, and glycemic surveillance in patients with diabetes.
  3. The frequency of diabetes screening in high-risk patients.  

RESEARCH DESIGN AND METHODS: This was a retrospective audit and included all adult patients who required a multiday HITH admission over a period of 6 months. Patients requiring PICC management or complex care were excluded. 

MAIN OUTCOME MEASURES: Prevalence of diabetes, hypoglycemic therapy, glycaemic surveillance and documentation, the length of stay, time to readmission and frequency of screening of high-risk patients. 

RESULTS: Sixty-nine of 287 (24%) had diabetes (95% CI 0.19 - 0.29). In the non-diabetes population (218/287),176 patients were high risk and 75/218 (42.6%) received screening for undiagnosed diabetes. Patients with diabetes were older, had a longer length of stay and were more likely to be readmitted (P < 0.07). 26% (18 patients) of admissions were related to diabetes complications. Blood glucose levels were documented at least once in 39 patients in the nursing record and 11 patients in the medical records. 33/69 patients with diabetes had a current HbAIC.

CONCLUSION: Diabetes prevalence in HITH is similar to other Melbourne public hospitals. Diabetes management is currently suboptimal in HITH. Improving diabetes care in HITH can yield favourable outcomes with reduced readmission rate, shorter length of stay and positive patient experience as it provides a platform for ongoing care and support to the patients in the community post discharge from the hospital. The study results will assist in planning for the protocol for Diabetes management in HITH.