The effect of the Vermont Diabetes Information System on inpatient and emergency room use: results from a randomized trial.
OBJECTIVE: To describe the effect of the Vermont Diabetes Information System (VDIS) on hospital and emergency room use DATA SOURCE: Statewide discharge database STUDY DESIGN: Randomized controlled trial of a decision support system for 7,412 adults with diabetes and their 64 primary care providers. DATA COLLECTION/ DATA EXTRACTION: Charges and dates for hospital admissions and emergency room care in Vermont during an average of 32 months of observation. Data from New York hospitals were not available. PRINCIPAL FINDINGS: Patients randomized to VDIS were admitted to the hospital less often than control subjects (0.17 admissions vs. 0.20; P=0.01) and generated lower hospital charges ($3,113 vs. $3,480; P=0.019). VDIS patients also had lower emergency room utilization (0.27 visits vs. 0.36; P<0.0001) and charges ($304 vs. $414; P<0.0001). The intervention was particularly effective in men and in older subjects. CONCLUSIONS: In spite of data limitations that tended to reduce the apparent effect of the system; this randomized, controlled trial showed that VDIS reduces hospitalization and emergency room utilization and expenses.
Pharmacy and Administrative Sciences, College of Pharmacy and Allied Health Professions, St. Albert's Hall, Room 108, St. John's University, Jamaica, NY, , , khans2@stjohns.edu.
Shamima
S
Khan
Charles D
CD
Maclean
Benjamin
B
Littenberg