Outpatient regulation of the insulin-requiring person with diabetes (an alternative to hospitalization).
One hundred and six insulin-requiring diabetic patients were randomly recruited to a pilot out-patient diabetes regulation and self-care program. The program was designed to offer an alternative to hospitalization. 89 patients completed the 5-day program. Fasting plasma glucose values at 5 days were significantly lower than initial levels (263 +/- 73 mg/dl vs 156 +/- 60 mg/dl; p-value less than 0.001). Long-term diabetic control was similarly improved at 6 months after entry when total glycosylated hemoglobin levels were significantly lower than initial values (13.8 +/- 2.8% vs 11.1 +/- 2.4%; p-value less than 0.0005). 17 patients failed to complete the program. Only four patients of the 89 were subsequently hospitalized with diabetes-related conditions. 445 hospital days were saved during the study period with calculated total dollar savings over $90,000. It is suggested that a structured out-patient program for diabetes regulation and self-care can be successfully developed and carried out at a significantly lower cost than hospitalization. Third party payors should take cognizance of these programs and appropriately include them in their health care coverage.
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics*; D003365:Costs and Cost Analysis; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010865:Pilot Projects; D011897:Random Allocation; D012646:Self Administration / Q000191:economics; D012648:Self Care / Q000191:economics*
D007328:Insulin