Background: Patients with diabetes mellitus constitute an increasing proportion of hospital admissions, placing significant demands on the health-care sector. An understanding of the factors associated with inpatient stay duration will provide the basis for improvements in efficiency.
Methods: A prospective audit was conducted (May 1st to June 30th, 2011) to characterise patients with diabetes admitted to the General Medicine Unit of a community public hospital. Main outcome measures include inpatient duration of stay, admission diagnoses, glycaemic control, access to health professionals, change in diabetic medications and diabetes-specific discharge planning. Comparison was made to patients without diabetes admitted concomitantly. Regression analysis was used to identify independent variables associated with duration of stay.
Results: Seventy-nine patients with diabetes (mean age 64 yrs; 53% male; mean HbA1c 8.8% [73mmol/mol] [SD 2.4]), and 227 patients without diabetes (mean age 67 yrs; 45% male) were admitted. Infection was the most common cause of admission in patients with and without diabetes (42% vs. 43.6% respectively). Patients with diabetes had a longer inpatient stay than those without diabetes (median stay 6 days vs. 5 days, P=0.03). In those with diabetes, age over 65 yrs and seeing fewer than 3 members of the diabetes multidisciplinary team in the two years prior to admission were independently associated with a longer stay (P=0.02).
Conclusions: Patients with diabetes mellitus represent 26% of medical inpatient admissions to a community public hospital, and had a longer inpatient stay than patients without diabetes. Independent predictors of inpatient duration in those with diabetes were insufficient community-based diabetes multidisciplinary review and age. Increased team-based diabetes management in the community may provide improved glycaemic control, increased surveillance to prevent diabetic complications, and thus shorten inpatient stay and reduce the burden on limited hospital resources.