The effectiveness of in-hospital interventions on reducing hospital length of stay and readmission of patients with Type 2 Diabetes Mellitus: A systematic review

Amal Chakraborty, Odette Pearson, Kate M. Schwartzkopff, Iris O'rourke, Isuru Ranasinghe, Peak Mann Mah, Robert Adams, Mark Boyd, Gary Wittert

Research output: Contribution to journalReview articlepeer-review

Abstract

Aim: This review aimed to assess the effectiveness of multifaceted in-hospital interventions for patients with type 2 diabetes mellitus on hospital readmission, hospital length of stay (LOS), and glycated haemoglobin (HbA1c). Methods: The search included MEDLINE, EMBASE, Emcare, Web of Science, PsycINFO and Google Scholar from 2007 to current date and restricted to English. The differences in outcome measures were calculated to determine the effectiveness. Results: The title and abstract of 3251 records were initially screened. Nine studies met the inclusion criteria. Most studies comprised of a wide range of intervention components and outcome measures. The reduction in hospital LOS ranged from 0.5 to 0.8 of a day. Clinically significant improvements in HbA1c concentration levels ranged from a mean reduction of −1.1 (±2.2) mmol/L to −2.8 (±2.7) mmol/L. There were no significant changes in hospital readmission rates and no evidence of the impact of HbA1c on hospital LOS and readmission. Common strategies in reducing hospital LOS and HbA1c were a dedicated care team, hospital wide approach, quality improvement focus, insulin therapy, early short-term intensive program, transition to primary care physicians, and on-going outpatient follow-up for at least 6–12 months. Conclusions: The findings illustrate that multifaceted in-hospital intervention for patients diagnosed with type 2 diabetes can contribute to improvements in hospital LOS and HbA1c concentration.

Original languageEnglish
Article number108363
Number of pages12
JournalDiabetes Research and Clinical Practice
Volume174
DOIs
Publication statusPublished - Apr 2021
Externally publishedYes

Keywords

  • Hospital length of stay
  • Hospital re-admission
  • In-hospital intervention
  • Indigenous populations
  • Type 2 diabetes mellitus

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