Pediatric Diabetes Outpatient Center at Rhode Island Hospital: The impact of changing initial diabetes education from inpatient to outpatient.
BACKGROUND
This study compared outcomes and costs for new-onset Type 1 diabetes mellitus (T1DM) patients educated at the outpatient versus inpatient settings.


METHODS
Retrospective study examining the following variables: 1) hemoglobin A1c (HbA1c), 2) severe hypoglycemia, 3) admissions for diabetic ketoacidosis (DKA) or ER visits, and 4) healthcare cost.


RESULTS
152 patients with new-onset T1DM from September 2007-August 2009. There were no differences between outpatient group (OG) and inpatient group (IG) in mean HbA1c levels at 1, 2 and 3 years post-diagnosis (OG 8%, 8.5%, 9.3%; IG 8.3%, 8.9%, 9%, p=0.51). Episodes of severe hypoglycemia, DKA, and ER visits were not different between the two groups. Mean total hospital costs for OG and pure OG were significantly less than IG (OG: $2886 vs. IG: $4925, p<0.001), (pure OG: $1044 vs. IG: $4925, p<0.0001).


CONCLUSIONS
Our study demonstrates that outpatient- based pediatric diabetes education lowers healthcare cost without compromising medical outcomes. [Full article available at http://rimed.org/rimedicaljournal-2017-02.asp].
Pediatric Endocrinologist, Pediatric Specialists of Virginia, Fairfax, VA.
Mia M
MM
Pingul
Summer Research Intern, College of Human Ecology, Cornell University, Ithaca, NY.
Erin M
EM
Mulvihill
Statistician, Information Services Department, Lifespan Corp., Providence, RI.
Steven E
SE
Reinert
Department of Internal Medicine, Chief, Division of Adult Endocrinology, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI.
Geetha
G
Gopalakrishnan
Psychologist, Department of Child and Adolescent Psychiatry, Hasbro Children's Hospital and Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, RI.
Wendy A
WA
Plante
Department of Pediatrics, Division of Pediatric Endocrinology, Baystate Children's Hospital, Springfield, MA.
Charlotte M
CM
Boney
Department of Pediatrics, Division of Pediatric Endocrinology at Rhode Island Hospital and Hasbro Children's Hospital/The Warren Alpert Medical School of Brown University, Providence, RI.
Shara R
SR
Bialo
Department of Pediatrics, Division of Pediatric Endocrinology at Rhode Island Hospital and Hasbro Children's Hospital/The Warren Alpert Medical School of Brown University, Providence, RI.
Jose Bernardo
JB
Quintos
D000293:Adolescent; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000191:economics* / Q000628:therapy; D016883:Diabetic Ketoacidosis / Q000175:diagnosis; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D017048:Health Care Costs; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis; D007297:Inpatients / Q000193:education*; D008297:Male; D010045:Outpatients / Q000193:education*; D010353:Patient Education as Topic / Q000191:economics*; D012189:Retrospective Studies; D012237:Rhode Island
D006442:Glycated Hemoglobin
HbA1c; diabetes education; inpatient; outpatient