title: An outpatient-focused program for childhood diabetes: design, implementation, and effectiveness.
abstract: Treatment of childhood diabetes mellitus has undergone many recent changes, one of which is an increasing focus on outpatient management. In mid-1988, the pediatric diabetes clinic at Texas Children's Hospital began adopting an outpatient-focused treatment program using a care team. This report reviews our experience during this transition. Between 1987 and 1990, the percentage of new-onset patients who were never admitted to the hospital increased from 0 to 38%. Length of stay for new-onset patients who are admitted has declined. The shift in program focus has also led to decreased diabetes-related readmissions and length of stay per readmission. Estimated total patient cost savings exceed $100,000 per year for new-onset patients alone. Our results regarding patient care and cost-effectiveness agree with reports from other such diabetes treatment programs and support greater acceptance and use of this outpatient-focused approach.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX.
authors.forename: P D
authors.initials: PD
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D003363:Cost Control / Q000639:trends; D003362:Cost-Benefit Analysis; D003922:Diabetes Mellitus, Type 1 / Q000191:economics / Q000628:therapy*; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000191:economics; D008297:Male; D010353:Patient Education as Topic / Q000191:economics; D013781:Texas