Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Factors Associated With Medical Inpatient Stay Duration Of Patients With Diabetes Mellitus Admitted To A Community Public Hospital (#353)

Melissa Lee 1 2 3 , Kevin Rowley 4 , Lillianne Liprino 3 , Jeffrey Brooks 3 , Brenda Cayzer 3 , Fiona Weedon 3 , Kate Bermingham 3 , Alicia Jenkins 2 , David O'Neal 1 2 3
  1. The University of Melbourne, Melbourne, Victoria, Australia
  2. St Vincent's Hospital, Melbourne, Victoria, Australia
  3. Werribee Mercy Hospital, Melbourne, Victoria, Australia
  4. Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia

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.