Expired CME Article
The Effects of Outpatient Management on Hospitalization for Ambulatory Care Sensitive Conditions Associated with Diabetes Mellitus
Abstract
Background: Ambulatory care sensitive conditions (ACSC) related to diabetes mellitus can potentially be prevented by good quality outpatient care. The purpose of this study was to evaluate which characteristics of ambulatory patients with diabetes were associated with ACSC hospitalizations.
Methods: Retrospective chart review of 65 adults with an ACSC diabetes-related hospitalization, and 130 controls with diabetes without ACSC hospitalizations. The primary outcome measure was the difference in hemoglobin A1c between groups.
Results: Patients with an ACSC hospitalization had poorer glucose control (mean A1c 9.24 versus 7.68, P < 0.001), but there was no difference in blood pressure or lipid control.
Conclusions: Prevention of diabetes-related hospitalizations related more closely to glycemic control, rather than other important aspects of comprehensive care.
Key Points
* Glucose control was the main factor in determining hospitalization for an ambulatory care sensitive condition related to diabetes.
* Blood pressure and lipid control were not associated with hospitalization for an ambulatory care-sensitive condition related to diabetes.
* Insulin use, but not oral hypoglycemic use, was related to hospitalization.
* Mean A1c was >9.5 in 39% of the hospitalized patients, versus 17% of the controls.
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