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Data & Rationale


Impact of Diabetes in Your Hospital: Opportunities for Clinical and Financial Improvement

The Health Economics of Inpatient Hyperglycemia & Diabetes and Its Management

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In this section you will find:

  • Slide Presentation - Data are presented that can be utilized in presentations to hospital administrators and others to inform, educate, and gain support for making improved glycemic control in the hospital an administrative priority. Included are slides that explore the costs of diabetes and hyperglycemia in the hospital as well as methods to avoid increased costs and possibly increased revenue.
  • Reference list - and suggested Key Readings
  • Selected published literature

             Please note that the slides in this section are being updated.

Key Points:

  • The economic burden of diabetes care is often viewed as a barrier to the implementation of efforts to control hyperglycemia in the hospital
  • Evidence exists to suggest that euglycemia may be financially beneficial
  • Controlling hyperglycemia in hospitalized patients – whether in patients with diagnosed diabetes or in patients with newly discovered hyperglycemia – has been shown to be cost effective in many different settings.

Examples of success

  • Cardiac surgical patients
    • Intensive glycemic control using IV insulin protocols decreased sternal wound infections and also decreased both cost and length of stay
  • In the MICU
    • Intensive glycemic control reduced blood sugar on average from 169 mg/dL to 123 mg/dL with a resultant reduction in catheter-related sepsis by 33.5%.  There was a resulting substantial cost savings.
    In non-ICU areas of the hospital
    • Lowering average blood sugar from 177 to 151 mg/dL was associated with a reduction in length of stay (LOS) from 6.01 to 5.75 days (0.26 days), with no reduction in LOS for non-hyperglycemic patients followed simultaneously
    • “Throughput value” calculated as incremental inpatient volume x revenue margin for this hospital was $2.2 million per year
  • Intensified management protocol by a diabetes management team
    • Resulted in correct coding and treatment of previously unrecognized hyperglycemic patients. Length of stay was reduced for both primary and secondary diagnoses, and readmission rates declined

Finally:

Optimizing glycemic management is not only medically effective, saving lives and reducing morbidity, but it is also cost-effective for health care systems.

 

Documents in this section

Date
Author
Document
2010
AACE
2009
AACE
2009
Curkendall
2009
Falciglia
2008
Sadhu
2007
Kim
2006
CDC
2006
Devos
2006
Furnary
2006
Krinsley
2006
Newton
2006
Olson
2006
Van den Berghe
2005
Svensson
2004
Abourizk
2004
Ahmann
2004
Clement
2004
Furnary
2004
Garber
2004
Grey
2004
Krinsley
2004
Levetan
2004
Van den Berghe
2003
Estrada
2003
Furnary
2003
Heaton
2003
Hogan
2003
Krinsley
2003
No authors listed
2002
Umpierrez
2002
Williams
2001
Gilman
2001
Menzin
2001
Van den Berghe
2001
Wagner
2000
Capes
1999
Furnary
1998
Levetan
1997
Koproski
1997
Zerr