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Erschienen in: Journal of Diabetes & Metabolic Disorders 2/2023

01.07.2023 | Research article

Associations between Outpatient Laboratory Test Age and Healthcare Utilization in Type 2 Diabetes Care

verfasst von: Kevin Wiley, Justin Blackburn, Eneida Mendonca, Nir Menachemi, Mary De Groot, Joshua R. Vest

Erschienen in: Journal of Diabetes & Metabolic Disorders | Ausgabe 2/2023

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Abstract

Purpose

To examine the longitudinal relationship between the age or shelf-life of common type 2 diabetes laboratory tests for serum creatinine, cholesterol, and glycated hemoglobin A1c conducted in outpatient settings and subsequent inpatient hospitalizations and emergency department visits.

Methods

This study analyzes panel data from two healthcare delivery systems’ electronic health records (EHR) for patients aged 18 years and older managing type 2 diabetes. We used EHR data to quantify the age of three laboratory tests: serum creatinine, cholesterol, and glycated hemoglobin A1c. Encounter data were used to determine the frequency of inpatient hospitalizations and emergency department visits. Negative binomial regressions with fixed effects were performed to compute marginal effects, levels of statistical significance, and 95% confidence intervals.

Results

The average age for serum creatinine laboratory tests was 1.51 months (95%CI: 1.49–1.53). We computed older average ages for hemoglobin A1c (mean:6.17 months; 95%CI: 6.11–6.23) and serum creatinine tests (mean: 8.73; 95%CI: 8.65–8.81). Older laboratory tests were associated with an increase in the total expected counts of subsequent inpatient hospitalizations (ME = 0.047; p < 0.001) and ED visits (ME = 0.034; p < 0.001).

Conclusion

Findings from this study indicate that older type 2 diabetes laboratory tests are associated with increases in the total expected count of subsequent inpatient hospitalizations and emergency department visits. Future research should examine the actionability of laboratory test values to determine associations with healthcare outcomes.
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Literatur
1.
Zurück zum Zitat Panser LA, Naessens JM, Nobrega FT, Palumbo PJ, Ballard DJ. Utilization trends and risk factors for hospitalization in diabetes mellitus. Mayo Clin Proc. 1990;65(9):1171–84.CrossRefPubMed Panser LA, Naessens JM, Nobrega FT, Palumbo PJ, Ballard DJ. Utilization trends and risk factors for hospitalization in diabetes mellitus. Mayo Clin Proc. 1990;65(9):1171–84.CrossRefPubMed
2.
Zurück zum Zitat Rosenthal MJ, Fajardo M, Gilmore S, Morley JE, Naliboff BD. Hospitalization and mortality of diabetes in older adults. A 3-year prospective study. Diabetes Care. 1998;21(2):231–5.CrossRefPubMed Rosenthal MJ, Fajardo M, Gilmore S, Morley JE, Naliboff BD. Hospitalization and mortality of diabetes in older adults. A 3-year prospective study. Diabetes Care. 1998;21(2):231–5.CrossRefPubMed
4.
Zurück zum Zitat US Preventive Services Task Force, Davidson KW, Barry MJ, et al. Screening for Prediabetes and Type 2 diabetes: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;326(8):736–43.CrossRef US Preventive Services Task Force, Davidson KW, Barry MJ, et al. Screening for Prediabetes and Type 2 diabetes: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;326(8):736–43.CrossRef
5.
Zurück zum Zitat Hess R, Bryce CL, Paone S, et al. Exploring challenges and potentials of personal health records in diabetes self-management: implementation and initial assessment. Telemed J E Health. 2007;13(5):509–17.CrossRefPubMed Hess R, Bryce CL, Paone S, et al. Exploring challenges and potentials of personal health records in diabetes self-management: implementation and initial assessment. Telemed J E Health. 2007;13(5):509–17.CrossRefPubMed
6.
Zurück zum Zitat Vo MT, Uratsu CS, Estacio KR, et al. Prompting patients with poorly controlled diabetes to identify visit Priorities before Primary Care visits: a pragmatic cluster Randomized Trial. J Gen Intern Med. 2019;34(6):831–8.CrossRefPubMedPubMedCentral Vo MT, Uratsu CS, Estacio KR, et al. Prompting patients with poorly controlled diabetes to identify visit Priorities before Primary Care visits: a pragmatic cluster Randomized Trial. J Gen Intern Med. 2019;34(6):831–8.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Dusheiko M, Doran T, Gravelle H, Fullwood C, Roland M. Does higher quality of diabetes management in family practice reduce unplanned hospital admissions? Health Serv Res. 2011;46(1 Pt 1):27–46.CrossRefPubMedPubMedCentral Dusheiko M, Doran T, Gravelle H, Fullwood C, Roland M. Does higher quality of diabetes management in family practice reduce unplanned hospital admissions? Health Serv Res. 2011;46(1 Pt 1):27–46.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Nelson LA, Wallston KA, Kripalani S, LeStourgeon LM, Williamson SE, Mayberry LS. Assessing barriers to diabetes medication adherence using the information-motivation-behavioral skills model. Diabetes Res Clin Pract. 2018;142:374–84.CrossRefPubMedPubMedCentral Nelson LA, Wallston KA, Kripalani S, LeStourgeon LM, Williamson SE, Mayberry LS. Assessing barriers to diabetes medication adherence using the information-motivation-behavioral skills model. Diabetes Res Clin Pract. 2018;142:374–84.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Bowen ME, Merchant Z, Abdullah K, Bhat D, Fish J, Halm EA. Patient, provider, and System factors Associated with failure to Follow-Up elevated glucose results in patients without diagnosed diabetes. Health Serv Res Manag Epidemiol. 2017;4:2333392817721647.PubMedPubMedCentral Bowen ME, Merchant Z, Abdullah K, Bhat D, Fish J, Halm EA. Patient, provider, and System factors Associated with failure to Follow-Up elevated glucose results in patients without diagnosed diabetes. Health Serv Res Manag Epidemiol. 2017;4:2333392817721647.PubMedPubMedCentral
10.
Zurück zum Zitat O’Connor PJ. Organizing diabetes care: identify, monitor, prioritize, intensify. Diabetes Care. 2001;24(9):1515–6.CrossRefPubMed O’Connor PJ. Organizing diabetes care: identify, monitor, prioritize, intensify. Diabetes Care. 2001;24(9):1515–6.CrossRefPubMed
11.
Zurück zum Zitat Francis BH, Song X, Andrews LM, et al. Progression to type 2 diabetes, healthcare utilization, and cost among pre-diabetic patients with or without comorbid hypertension. Curr Med Res Opin. 2011;27(4):809–19.CrossRefPubMed Francis BH, Song X, Andrews LM, et al. Progression to type 2 diabetes, healthcare utilization, and cost among pre-diabetic patients with or without comorbid hypertension. Curr Med Res Opin. 2011;27(4):809–19.CrossRefPubMed
12.
Zurück zum Zitat Chouvarda IG, Goulis DG, Lambrinoudaki I, Maglaveras N. Connected health and integrated care: toward new models for chronic disease management. Maturitas. 2015;82(1):22–7.CrossRefPubMed Chouvarda IG, Goulis DG, Lambrinoudaki I, Maglaveras N. Connected health and integrated care: toward new models for chronic disease management. Maturitas. 2015;82(1):22–7.CrossRefPubMed
13.
Zurück zum Zitat Liaw ST, Rahimi A, Ray P, et al. Towards an ontology for data quality in integrated chronic disease management: a realist review of the literature. Int J Med Inform. 2013;82(1):10–24.CrossRefPubMed Liaw ST, Rahimi A, Ray P, et al. Towards an ontology for data quality in integrated chronic disease management: a realist review of the literature. Int J Med Inform. 2013;82(1):10–24.CrossRefPubMed
14.
Zurück zum Zitat Shahraz S, Pittas AG, Saadati M, Thomas CP, Lundquist CM, Kent DM. Change in testing, awareness of Hemoglobin A1c result, and Glycemic Control in US adults, 2007–2014. JAMA. 2017;318(18):1825–7.CrossRefPubMedPubMedCentral Shahraz S, Pittas AG, Saadati M, Thomas CP, Lundquist CM, Kent DM. Change in testing, awareness of Hemoglobin A1c result, and Glycemic Control in US adults, 2007–2014. JAMA. 2017;318(18):1825–7.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Comino EJ, Harris MF, Islam MDF, et al. Impact of diabetes on hospital admission and length of stay among a general population aged 45 year or more: a record linkage study. BMC Health Serv Res. 2015;15:12.CrossRefPubMedPubMedCentral Comino EJ, Harris MF, Islam MDF, et al. Impact of diabetes on hospital admission and length of stay among a general population aged 45 year or more: a record linkage study. BMC Health Serv Res. 2015;15:12.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Samuels TA, Cohen D, Brancati FL, Coresh J, Kao WHL. Delayed diagnosis of incident type 2 diabetes mellitus in the ARIC study. Am J Manag Care. 2006;12(12):717–24.PubMed Samuels TA, Cohen D, Brancati FL, Coresh J, Kao WHL. Delayed diagnosis of incident type 2 diabetes mellitus in the ARIC study. Am J Manag Care. 2006;12(12):717–24.PubMed
17.
Zurück zum Zitat Patel V, McNamara L, Dullabh P, Sawchuk ME, Swain M. Variation in interoperability across clinical laboratories nationwide. Int J Med Inform. 2017;108:175–84.CrossRefPubMedPubMedCentral Patel V, McNamara L, Dullabh P, Sawchuk ME, Swain M. Variation in interoperability across clinical laboratories nationwide. Int J Med Inform. 2017;108:175–84.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Gazmararian JA, Ziemer DC, Barnes C. Perception of barriers to self-care management among diabetic patients. Diabetes Educ. 2009;35(5):778–88.CrossRefPubMed Gazmararian JA, Ziemer DC, Barnes C. Perception of barriers to self-care management among diabetic patients. Diabetes Educ. 2009;35(5):778–88.CrossRefPubMed
19.
Zurück zum Zitat Delaronde S. Barriers to A1C testing among a managed care population. Diabetes Educ. 2005;31(2):235–9.CrossRefPubMed Delaronde S. Barriers to A1C testing among a managed care population. Diabetes Educ. 2005;31(2):235–9.CrossRefPubMed
20.
Zurück zum Zitat McDonald CJ, Overhage JM, Barnes M, et al. The Indiana network for patient care: a working local health information infrastructure. An example of a working infrastructure collaboration that links data from five health systems and hundreds of millions of entries. Health Aff. 2005;24(5):1214–20.CrossRef McDonald CJ, Overhage JM, Barnes M, et al. The Indiana network for patient care: a working local health information infrastructure. An example of a working infrastructure collaboration that links data from five health systems and hundreds of millions of entries. Health Aff. 2005;24(5):1214–20.CrossRef
21.
Zurück zum Zitat Hills RA, Revere D, Altamore R, Abernethy NF, Lober WB. Timeliness and data element completeness of immunization data in Washington State in 2010: a comparison of data exchange methods. AMIA Annu Symp Proc. 2012;2012:340–349. Hills RA, Revere D, Altamore R, Abernethy NF, Lober WB. Timeliness and data element completeness of immunization data in Washington State in 2010: a comparison of data exchange methods. AMIA Annu Symp Proc. 2012;2012:340–349.
23.
Zurück zum Zitat Hu Z, Melton GB, Arsoniadis EG, Wang Y, Kwaan MR, Simon GJ. Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record. J Biomed Inform. 2017;68:112–20.CrossRefPubMedPubMedCentral Hu Z, Melton GB, Arsoniadis EG, Wang Y, Kwaan MR, Simon GJ. Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record. J Biomed Inform. 2017;68:112–20.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Goel MS, Brown TL, Williams A, Hasnain-Wynia R, Thompson JA, Baker DW. Disparities in enrollment and use of an electronic patient portal. J Gen Intern Med. 2011;26(10):1112–6.CrossRefPubMedPubMedCentral Goel MS, Brown TL, Williams A, Hasnain-Wynia R, Thompson JA, Baker DW. Disparities in enrollment and use of an electronic patient portal. J Gen Intern Med. 2011;26(10):1112–6.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Shrivastav M, Gibson W Jr, Shrivastav R, et al. Type 2 Diabetes Management in Primary Care: the role of Retrospective, Professional continuous glucose monitoring. Diabetes Spectr. 2018;31(3):279–87.CrossRefPubMedPubMedCentral Shrivastav M, Gibson W Jr, Shrivastav R, et al. Type 2 Diabetes Management in Primary Care: the role of Retrospective, Professional continuous glucose monitoring. Diabetes Spectr. 2018;31(3):279–87.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Bell SK, Delbanco T, Elmore JG, et al. Frequency and types of patient-reported errors in Electronic Health Record Ambulatory Care Notes. JAMA Netw Open. 2020;3(6):e205867–7.CrossRefPubMedPubMedCentral Bell SK, Delbanco T, Elmore JG, et al. Frequency and types of patient-reported errors in Electronic Health Record Ambulatory Care Notes. JAMA Netw Open. 2020;3(6):e205867–7.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Faulconer ER, de Lusignan S. An eight-step method for assessing diagnostic data quality in practice: chronic obstructive pulmonary disease as an exemplar. Inf Prim Care. 2004;12(4):243–54. Faulconer ER, de Lusignan S. An eight-step method for assessing diagnostic data quality in practice: chronic obstructive pulmonary disease as an exemplar. Inf Prim Care. 2004;12(4):243–54.
28.
Zurück zum Zitat Botsis T, Hartvigsen G, Chen F, Weng C. Secondary Use of EHR: Data Quality Issues and Informatics Opportunities. AMIA Jt Summits Transl Sci Proc. 2010;2010:1–5. Botsis T, Hartvigsen G, Chen F, Weng C. Secondary Use of EHR: Data Quality Issues and Informatics Opportunities. AMIA Jt Summits Transl Sci Proc. 2010;2010:1–5.
29.
Zurück zum Zitat Goudswaard AN, Lam K, Stolk RP, Rutten GEHM. Quality of recording of data from patients with type 2 diabetes is not a valid indicator of quality of care. A cross-sectional study. Fam Pract. 2003;20(2):173–7.CrossRefPubMed Goudswaard AN, Lam K, Stolk RP, Rutten GEHM. Quality of recording of data from patients with type 2 diabetes is not a valid indicator of quality of care. A cross-sectional study. Fam Pract. 2003;20(2):173–7.CrossRefPubMed
31.
Zurück zum Zitat Cappiello C, Francalanci C, Pernici B. Time-Related factors of Data Quality in Multichannel Information Systems. J Manage Inform Syst. 2003;20(3):71–92.CrossRef Cappiello C, Francalanci C, Pernici B. Time-Related factors of Data Quality in Multichannel Information Systems. J Manage Inform Syst. 2003;20(3):71–92.CrossRef
32.
Zurück zum Zitat Cappiello C, Francalanci C, Pernici B. Data quality assessment from the user’s perspective. In: Proceedings of the 2004 International Workshop on Information Quality in Information Systems. IQIS ’04. Association for Computing Machinery; 2004:68–73. Cappiello C, Francalanci C, Pernici B. Data quality assessment from the user’s perspective. In: Proceedings of the 2004 International Workshop on Information Quality in Information Systems. IQIS ’04. Association for Computing Machinery; 2004:68–73.
33.
Zurück zum Zitat Steiner C, Barrett M, Hunter K. Hospital Readmissions and multiple Emergency Department visits, in selected States, 2006–2007: statistical brief #90. Healthcare cost and utilization project (HCUP) statistical briefs. Agency for Healthcare Research and Quality (US); 2010. Steiner C, Barrett M, Hunter K. Hospital Readmissions and multiple Emergency Department visits, in selected States, 2006–2007: statistical brief #90. Healthcare cost and utilization project (HCUP) statistical briefs. Agency for Healthcare Research and Quality (US); 2010.
34.
Zurück zum Zitat Bo S, Ciccone G, Grassi G, et al. Patients with type 2 diabetes had higher rates of hospitalization than the general population. J Clin Epidemiol. 2004;57(11):1196–201.CrossRefPubMed Bo S, Ciccone G, Grassi G, et al. Patients with type 2 diabetes had higher rates of hospitalization than the general population. J Clin Epidemiol. 2004;57(11):1196–201.CrossRefPubMed
35.
Zurück zum Zitat Li Y, Sperrin M, Martin GP, Ashcroft DM, van Staa TP. Examining the impact of data quality and completeness of electronic health records on predictions of patients’ risks of cardiovascular disease. Int J Med Inform. 2020;133:104033.CrossRefPubMed Li Y, Sperrin M, Martin GP, Ashcroft DM, van Staa TP. Examining the impact of data quality and completeness of electronic health records on predictions of patients’ risks of cardiovascular disease. Int J Med Inform. 2020;133:104033.CrossRefPubMed
Metadaten
Titel
Associations between Outpatient Laboratory Test Age and Healthcare Utilization in Type 2 Diabetes Care
verfasst von
Kevin Wiley
Justin Blackburn
Eneida Mendonca
Nir Menachemi
Mary De Groot
Joshua R. Vest
Publikationsdatum
01.07.2023
Verlag
Springer International Publishing
Erschienen in
Journal of Diabetes & Metabolic Disorders / Ausgabe 2/2023
Elektronische ISSN: 2251-6581
DOI
https://doi.org/10.1007/s40200-023-01250-0

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