Inpatient to Outpatient Transfer of Care in Urban Patients with Diabetes: Patterns and Determinants of Immediate Postdischarge Follow-up

Kate Wheeler, Rochanda Crawford, Debra McAdams, Sonia Benel, Virginia G. Dunbar, Jane M. Caudle, Christopher George, Imad El-Kebbi, Daniel L. Gallina, David C. Ziemer, Curtiss B. Cook

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: A key opportunity for continuing diabetes care is to assure outpatient follow-up after hospitalization. To delineate patterns and factors associated with having an ambulatory care visit, we examined immediate postdischarge follow-up among a cohort of urban, hospitalized patients with diabetes mellitus. Methods: Retrospective study of 658 inpatients of a municipal hospital. Primary data sources were inpatient surveys and electronic records. Results: Patients were stratified into outpatient follow-up (69%), acute care follow-up (15%), and those with no follow-up (16%); differences between groups were detected for age (P=.02), percentage discharged with insulin (P=.03), and percentage receiving a full discount for care (P<.001). Among patients with a postdischarge visit, 43% were seen in our specialty diabetes clinic, and 26% in a primary care site. Adjusted analyses showed any follow-up visit significantly decreased with having to pay for care. The odds of coming to the Diabetes Clinic increased if patients were discharged with insulin, had new-onset diabetes, or had a direct referral. Conclusions: In this patient cohort, most individuals accomplished a postdischarge visit, but a substantial percentage had an acute care visit or no documented follow-up. New efforts need to be devised to track patients after discharge to assure care is achieved, especially in this patient population particularly vulnerable to diabetes.

Original languageEnglish (US)
Pages (from-to)447-453
Number of pages7
JournalArchives of Internal Medicine
Volume164
Issue number4
DOIs
StatePublished - Feb 23 2004

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Ambulatory Care
Inpatients
Outpatients
Insulin
Municipal Hospitals
Aftercare
Patient Discharge
Information Storage and Retrieval
Vulnerable Populations
Primary Health Care
Diabetes Mellitus
Hospitalization
Referral and Consultation
Retrospective Studies

ASJC Scopus subject areas

  • Internal Medicine

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Inpatient to Outpatient Transfer of Care in Urban Patients with Diabetes : Patterns and Determinants of Immediate Postdischarge Follow-up. / Wheeler, Kate; Crawford, Rochanda; McAdams, Debra; Benel, Sonia; Dunbar, Virginia G.; Caudle, Jane M.; George, Christopher; El-Kebbi, Imad; Gallina, Daniel L.; Ziemer, David C.; Cook, Curtiss B.

In: Archives of Internal Medicine, Vol. 164, No. 4, 23.02.2004, p. 447-453.

Research output: Contribution to journalArticle

Wheeler, K, Crawford, R, McAdams, D, Benel, S, Dunbar, VG, Caudle, JM, George, C, El-Kebbi, I, Gallina, DL, Ziemer, DC & Cook, CB 2004, 'Inpatient to Outpatient Transfer of Care in Urban Patients with Diabetes: Patterns and Determinants of Immediate Postdischarge Follow-up', Archives of Internal Medicine, vol. 164, no. 4, pp. 447-453. https://doi.org/10.1001/archinte.164.4.447
Wheeler, Kate ; Crawford, Rochanda ; McAdams, Debra ; Benel, Sonia ; Dunbar, Virginia G. ; Caudle, Jane M. ; George, Christopher ; El-Kebbi, Imad ; Gallina, Daniel L. ; Ziemer, David C. ; Cook, Curtiss B. / Inpatient to Outpatient Transfer of Care in Urban Patients with Diabetes : Patterns and Determinants of Immediate Postdischarge Follow-up. In: Archives of Internal Medicine. 2004 ; Vol. 164, No. 4. pp. 447-453.
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