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BioMed Research International
Volume 2014 (2014), Article ID 781670, 11 pages
http://dx.doi.org/10.1155/2014/781670
Research Article

Impact of HbA1c Measurement on Hospital Readmission Rates: Analysis of 70,000 Clinical Database Patient Records

1Department of Computer Science, Virginia Commonwealth University, Richmond, VA 23284, USA
2Department of Health Administration, Virginia Commonwealth University, Richmond, VA 23298, USA
3Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA
4Department of Computer Science and Numerical Analysis, University of Cordoba, 14071 Cordoba, Spain
5IITiS Polish Academy of Sciences, 44-100 Gliwice, Poland
6Department of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA

Received 19 November 2013; Revised 25 February 2014; Accepted 7 March 2014; Published 3 April 2014

Academic Editor: Ali Rizvi

Copyright © 2014 Beata Strack et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Management of hyperglycemia in hospitalized patients has a significant bearing on outcome, in terms of both morbidity and mortality. However, there are few national assessments of diabetes care during hospitalization which could serve as a baseline for change. This analysis of a large clinical database (74 million unique encounters corresponding to 17 million unique patients) was undertaken to provide such an assessment and to find future directions which might lead to improvements in patient safety. Almost 70,000 inpatient diabetes encounters were identified with sufficient detail for analysis. Multivariable logistic regression was used to fit the relationship between the measurement of HbA1c and early readmission while controlling for covariates such as demographics, severity and type of the disease, and type of admission. Results show that the measurement of HbA1c was performed infrequently (18.4%) in the inpatient setting. The statistical model suggests that the relationship between the probability of readmission and the HbA1c measurement depends on the primary diagnosis. The data suggest further that the greater attention to diabetes reflected in HbA1c determination may improve patient outcomes and lower cost of inpatient care.