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The Diabetes Transition of Hospital Care (DiaTOHC) Pilot Study: A Randomized Controlled Trial of an Intervention Designed to Reduce Readmission Risk of Adults with Diabetes
Gogineni, Preethi Deak, Andrew Watts, Samantha Recco, Dominic Dillard, Felicia Karunakaran, Abhijana Kondamuri, Neil
Gogineni, Preethi
Deak, Andrew
Watts, Samantha
Recco, Dominic
Dillard, Felicia
Karunakaran, Abhijana
Kondamuri, Neil
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Journal article
Date
2022-03-08
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Medicine
Epidemiology and Biostatistics
Biomedical Education and Data Science
Epidemiology and Biostatistics
Biomedical Education and Data Science
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http://dx.doi.org/10.3390/jcm11061471
Abstract
Hospital readmission within 30 days of discharge (30-day readmission) is a high-priority quality measure and cost target. The purpose of this study was to explore the feasibility and efficacy of the Diabetes Transition of Hospital Care (DiaTOHC) Program on readmission risk in high-risk adults with diabetes. This was a non-blinded pilot randomized controlled trial (RCT) that compared usual care (UC) to DiaTOHC at a safety-net hospital. The primary outcome was all-cause 30-day readmission. Between 16 October 2017 and 30 May 2019, 93 patients were randomized. In the intention-to-treat (ITT) population, 14 (31.1%) of 45 DiaTOHC subjects and 15 (32.6%) of 46 UC subjects had a 30-day readmission, while 35.6% DiaTOHC and 39.1% UC subjects had a 30-day readmission or ED visit. The Intervention–UC cost ratio was 0.33 (0.13–0.79) 95%CI. At least 93% of subjects were satisfied with key intervention components. Among the 69 subjects with baseline HbA1c >7.0% (53 mmol/mol), 30-day readmission rates were 23.5% (DiaTOHC) and 31.4% (UC) and composite 30-day readmission/ED visit rates were 26.5% (DiaTOHC) and 40.0% (UC). In this subgroup, the Intervention–UC cost ratio was 0.21 (0.08–0.58) 95%CI. The DiaTOHC Program may be feasible and may decrease combined 30-day readmission/ED visit risk as well as healthcare costs among patients with HbA1c levels >7.0% (53 mmol/mol).
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Rubin, D.J.; Gogineni, P.; Deak, A.; Vaz, C.; Watts, S.; Recco, D.; Dillard, F.; Wu, J.; Karunakaran, A.; Kondamuri, N.; et al. The Diabetes Transition of Hospital Care (DiaTOHC) Pilot Study: A Randomized Controlled Trial of an Intervention Designed to Reduce Readmission Risk of Adults with Diabetes. J. Clin. Med. 2022, 11, 1471. https://doi.org/10.3390/jcm11061471
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Journal of Clinical Medicine (JCM),, Vol. 11, Iss. 6
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