Original ArticleBenchmarking Glycemic Control In U.S. Hospitals
Section snippets
INTRODUCTION
The prevalence of diabetes mellitus continues to increase and currently affects about 8% of the U.S. population. Costs associated with inpatient diabetes care continue to rise as well 1., 2.. In-hospital blood glucose control has received considerable attention over the years 3., 4., 5., 6., and several organizations have embraced the importance of managing inpatient hyperglycemia; furthermore, they have developed guidelines and educational programs to assist practitioners with management 7., 8.
METHODS
This study was reviewed and considered exempt from requiring review by the Mayo Clinic Institutional Review Board.
Characteristics of Participating Hospitals and Blood Glucose Measurement Data
The current data set (derived from 635 hospitals) included 149 hospitals that were new to the RALS system since the last analysis, published in 2011 (13). Additionally, 87 institutions that were included previously no longer reported data. The greatest number of new additions and withdrawals were characteristically the smallest hospitals (< 200 beds), urban community hospitals, and Southern hospitals (Table 1). The data set included a large sample of POC-BG values, patients, and hospitalizations
DISCUSSION
The number of hospitalizations associated with diabetes and their related costs continue to increase. Thus, inpatient diabetes care will pose a significant challenge and burden to the U.S. healthcare system 1., 2.. Optimal inpatient glycemic control is advocated by many professional organizations and healthcare institutions 3., 7., 8., 9., 11.. Assessment of glycemic control may become of greater importance to individual hospitals as healthcare reimbursements become tied to outcome. As many
CONCLUSION
Despite these limitations, we report the largest data set of glycemic measures in U.S. hospitals available to date. Although the types and numbers of facilities reporting POC-BG data have varied from one published report to the next, consistent relationships between blood glucose control and hospital characteristics were observed across analyses. Given these hospital-based differences, along with nonstandard and possibly changing technologies used to measure POC-BG values, more discussion is
DISCLOSURE
Gail L. Kongable is an employee of the Epsilon and Alere Informatics Solutions, Charlottesville, VA. Jianfen Shu has received statistical consultant grand from the Epsilon Group, Charlottesville, VA. Denise R. Zito is an employee of Alere Informatics Solution, Charlottesville, VA. The other authors have no multiplicity of interest to disclose.
ACKNOWLEDGMENT
Alere Informatics provides the RALS-Plus laboratory information system software to hospitals. Roche Diagnostics has provided grant support to generate glucose management data reports as value-added for their hospital clients. This analysis was supported entirely by Alere Informatics (as the Epsilon Group), Charlottesville, Virginia, and a contractual arrangement is in place between Mayo Clinic and Alere Informatics.
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Published as a Rapid Electronic Article in Press at http://www.endocrinepractice.org on March 18, 2014. DOI: 10.4158/EP13516.OR