Predicators of Unplanned Readmission of Patients with Type 2 Diabetes Mellitus

• Main Authors: Chin-Pen Kao, 高金盆
• Other Authors: Chii-Jun Chiou
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/21757804469829322671

碩士 === 高雄醫學大學 === 護理學研究所 === 98 === Objective: Type 2 diabetes mellitus (DM) is a chronic systemic disease with multiple organ complications including arteriosclerosis, neuropathy, nephropathy and retinopathy. To investigate the readmission rate and significant predicting factors of readmission from discharged diabetic inpatients in a medical center in Taiwan. Research design and methods: A case control study was conducted in a medical center in southern Taiwan. Patients who were discharged from a medical center and were diagnosed with type 2 DM from 2008 January 1 to 2008 December 31 were recruited. A 1:2 individual-matched case-control study was conducted. Individuals of discharged type 2 DM inpatients in a medical center were matched on sex and age (±5 years old) of cases were selected as controls. 148 type 2 DM patients with unplanned readmission history of 30 days after discharge were recruited to join the experimental group; 298 type 2 DM patients without unplanned readmission history of 30 days after discharge were recruited to join the control group. Data will be collected through medical records. Results: Study results found that the readmission rate of type 2 DM in the study population was 10.02% (674/6725). The significant predicting factors of readmission were residents in general village（OR=0.50, 95% CI: 0.30-0.85, p< .05）; Charlson comorbidity index score （OR=1.33, 95% CI: 1.16 -1.57, p< .001）; the numbers of hospital admission one year ago（OR=2.11, 95% CI: 1.47-3.03, p< .001）; retinopahty（OR= 2.62, 95% CI: 1.08-6.37, p< .01）; the plasma glucose（OR=1.01, 95% CI: 1.00-1.01, p< .01）; wound at dishcarge（OR=0.29, 95% CI: 0.15-0.53, p< .001）; length of stay（OR=1.07, 95% CI: 1.02-1.12, p< .01）; learning device education（OR=2.71, 95% CI: 1.27-5.75, p< .01）and diabetes education program （OR=0.75, 95% CI: 0.67-0.85, p< .001）. Conclusions: The results of this study may enhance Charlson comorbidity index score and the numbers of hospital admission one year ago to the determinants of preparing discharge risk group among DM patients. As a result, effective strategies of blood sugar control, regular retina examined, wound care learning device education and long-term admission periods can be developed, and the readmission rate of the DM patients may be reduced.