Predictors of Emergency and Hospital Admission in a Low-income Population with Type 2 Diabetes

2.50
Hdl Handle:
http://hdl.handle.net/10755/160423
Type:
Presentation
Title:
Predictors of Emergency and Hospital Admission in a Low-income Population with Type 2 Diabetes
Abstract:
Predictors of Emergency and Hospital Admission in a Low-income Population with Type 2 Diabetes
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2003
Author:Kreulen, Grace
Contact Address:CON, 221 W. Fee Hall, East Lansing, MI, 48824-1316, USA
Co-Authors:Manfred Stommel; Julie Lundvick; Mary Wilson; David Faichney
The purpose of this study is to identify characteristics of low-income persons 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 in which costs attributed to hospitalization are estimated to be $27 billion per year. Lezzoni’s (1997) effectiveness model informed the identification of clinical and nonclinical dimensions of risk with relevance to diabetes management. Data were collected by means of a one-year audit of a sample of charts (N=446) representing an ethnically diverse, low-income population. Access to care, utilization, risk behavior, self-care behavior, demographic, social support, and clinical indicator data were studied. Eighteen percent of the sample had at least one emergency department or hospital admission. 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). Interventions designed to be relevant to men that target improved glycemic control, promotion of exercise and limiting alcohol intake, as well as the enhancement of patient-clinic communication strategies and the nurse practitioner role in providing primary care to low-income people with diabetes may decrease hospitalization 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. AN: MN030274
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePredictors of Emergency and Hospital Admission in a Low-income Population with Type 2 Diabetesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160423-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Predictors of 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">Midwest Nursing Research Society</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</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">CON, 221 W. Fee Hall, East Lansing, MI, 48824-1316, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Manfred Stommel; Julie Lundvick; Mary Wilson; David Faichney </td></tr><tr><td colspan="2" class="item-abstract">The purpose of this study is to identify characteristics of low-income persons 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 in which costs attributed to hospitalization are estimated to be $27 billion per year. Lezzoni&rsquo;s (1997) effectiveness model informed the identification of clinical and nonclinical dimensions of risk with relevance to diabetes management. Data were collected by means of a one-year audit of a sample of charts (N=446) representing an ethnically diverse, low-income population. Access to care, utilization, risk behavior, self-care behavior, demographic, social support, and clinical indicator data were studied. Eighteen percent of the sample had at least one emergency department or hospital admission. 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). Interventions designed to be relevant to men that target improved glycemic control, promotion of exercise and limiting alcohol intake, as well as the enhancement of patient-clinic communication strategies and the nurse practitioner role in providing primary care to low-income people with diabetes may decrease hospitalization 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. AN: MN030274 </td></tr></table>en_GB
dc.date.available2011-10-26T22:55:45Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:55:45Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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