Emergency and Hospital Admission in a Low-Income Population with Type 2 Diabetes

2.50
Hdl Handle:
http://hdl.handle.net/10755/148245
Type:
Presentation
Title:
Emergency and Hospital Admission in a Low-Income Population with Type 2 Diabetes
Abstract:
Emergency and Hospital Admission in a Low-Income Population with Type 2 Diabetes
Conference Sponsor:Sigma Theta Tau International
Conference Year:2003
Author:Kreulen, Grace J., RN, MSN, PhD
P.I. Institution Name:Michigan State University
Title:Assistant Professor
Co-Authors:Manfred Stommel, PhD
Objective. The purpose of this study is to identify characteristics of low-income adults receiving primary care for type 2 diabetes that place them at risk for high cost emergency department and hospital utilization. Diabetes is a high demand disease with costs attributed to hospitalization estimated at $27 billion per year. Low-income persons are at disproportionate risk for hospital utilization. Variables Studied. Iezzoni’s (1997) effectiveness model informed the identification of clinical and nonclinical dimensions of risk with relevance to diabetes. Access to care, utilization, risk behavior, self-care behavior, demographic, social support, and clinical indicator data were examined. Methods/Sample. Data were collected by a one-year audit of a sample of charts (N=446) representing an ethnically diverse, low-income adult population. The average subject was a 54-year-old female who had diabetes for 6 years and 3.7 medical diagnoses in addition to diabetes. Findings. Eighteen percent of the sample had at least one emergency department (ED) or hospital admission during the audit year (mean = .61 ± 1.7 ED admissions/year, .28 ± .85 hospital admissions/year). Results of logistic regression analysis revealed 6 significant (p<.05) predictors of admission: moderate/severe acute glycemic events (odds ratio [OR], 2.88), male sex (OR, 0.51), inactivity (OR, 0.28), alcohol abuse (OR, 2.57), clinic phone visits (OR, 1.05), and not receiving primary care exclusively from nurse practitioner/physician assistant providers during the audit year (OR, 0.30). Conclusions/Implications. Interventions designed to be relevant to men that target improved glycemic control, promotion of exercise and limiting alcohol intake, as well as clinical strategies that enhance patient-clinic communication and the nurse practitioner role in providing primary care to low-income people with diabetes may decrease hospital admission rates in this population. Diabetes care protocols should be tailored to address these specific areas and to empower better self-management and health care system utilization in low-income persons with diabetes.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEmergency and Hospital Admission in a Low-Income Population with Type 2 Diabetesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148245-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Emergency and Hospital Admission in a Low-Income Population with Type 2 Diabetes</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kreulen, Grace J., RN, MSN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Michigan State University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">gkreulen@msu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Manfred Stommel, PhD</td></tr><tr><td colspan="2" class="item-abstract">Objective. The purpose of this study is to identify characteristics of low-income adults receiving primary care for type 2 diabetes that place them at risk for high cost emergency department and hospital utilization. Diabetes is a high demand disease with costs attributed to hospitalization estimated at $27 billion per year. Low-income persons are at disproportionate risk for hospital utilization. Variables Studied. Iezzoni&rsquo;s (1997) effectiveness model informed the identification of clinical and nonclinical dimensions of risk with relevance to diabetes. Access to care, utilization, risk behavior, self-care behavior, demographic, social support, and clinical indicator data were examined. Methods/Sample. Data were collected by a one-year audit of a sample of charts (N=446) representing an ethnically diverse, low-income adult population. The average subject was a 54-year-old female who had diabetes for 6 years and 3.7 medical diagnoses in addition to diabetes. Findings. Eighteen percent of the sample had at least one emergency department (ED) or hospital admission during the audit year (mean = .61 &plusmn; 1.7 ED admissions/year, .28 &plusmn; .85 hospital admissions/year). Results of logistic regression analysis revealed 6 significant (p&lt;.05) predictors of admission: moderate/severe acute glycemic events (odds ratio [OR], 2.88), male sex (OR, 0.51), inactivity (OR, 0.28), alcohol abuse (OR, 2.57), clinic phone visits (OR, 1.05), and not receiving primary care exclusively from nurse practitioner/physician assistant providers during the audit year (OR, 0.30). Conclusions/Implications. Interventions designed to be relevant to men that target improved glycemic control, promotion of exercise and limiting alcohol intake, as well as clinical strategies that enhance patient-clinic communication and the nurse practitioner role in providing primary care to low-income people with diabetes may decrease hospital admission rates in this population. Diabetes care protocols should be tailored to address these specific areas and to empower better self-management and health care system utilization in low-income persons with diabetes.</td></tr></table>en_GB
dc.date.available2011-10-26T09:42:22Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:42:22Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.