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Emergency room visit: a red-flag indicator for poor diabetes care
Z Stern1, R Calderon-Margalit, M Mazar
1Hadassah Hebrew University Hospital, Jerusalem, Israel. zvistern@hadassah.org.il
Diabetic Medicine : a Journal of the British Diabetic Association
|November 26, 2009
Summary
Emergency room (ER) visits for patients with diabetes indicate lower quality of care. Key quality indicators like cholesterol testing and ophthalmologist visits were linked to fewer ER admissions, highlighting areas for improved diabetes management.
Area of Science:
- Public Health
- Diabetes Care Management
- Health Services Research
Background:
- Effective diabetes mellitus (DM) management is crucial for preventing complications and reducing healthcare utilization.
- Emergency room (ER) admissions may signal deficiencies in community-based primary care for patients with DM.
Purpose of the Study:
- To investigate the association between emergency room (ER) admission and the quality of diabetes care received by patients.
- To identify specific quality of care indicators linked to ER utilization in Type 2 Diabetes Mellitus (DM) patients.
Main Methods:
- A nested case-control study was conducted within a large Israeli health maintenance organization (HMO).
- 919 ER-admitted patients with Type 2 DM were compared to 1952 non-admitted controls.
- Logistic regression analysis was used to assess the odds of ER admission based on quality of care measures, controlling for covariates.
Main Results:
- Key quality indicators were inversely associated with ER visits. These include cholesterol testing (OR 0.23), glycated hemoglobin testing (OR 0.26), and ophthalmologist visits (OR 0.47).
- Receiving recommendations to stop smoking showed a strong inverse association with ER admission (OR 0.10).
- All reported associations were statistically significant (P < 0.001 or P = 0.001).
Conclusions:
- Emergency room (ER) admission serves as a potential indicator of suboptimal diabetes care quality.
- Improving adherence to recommended diabetes care processes may reduce ER utilization among patients with Type 2 DM.
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