Key result
Primary diabetes discharge diagnosis linked to ~37% higher 30-day readmission risk versus secondary diagnosis.
Why the study?
Hospital readmission among people with diabetes is common and costly, and understanding differences based on whether diabetes is a primary or secondary discharge diagnosis could help prevent readmissions.
Does a primary discharge diagnosis of diabetes compared to a secondary discharge diagnosis increase the risk of 30-day all-cause hospital readmission in hospitalized adults with diabetes?
Cohort (n=8,054)
Does a primary discharge diagnosis of diabetes compared to a secondary discharge diagnosis increase the risk of 30-day all-cause hospital readmission in hospitalized adults with diabetes?
Absolute Event Rate: 22.2% vs 16.2%
p-value: p=< 0.01
Hospitalized adults with a primary discharge diagnosis of diabetes have a significantly higher 30-day readmission risk compared to those with a secondary diagnosis of diabetes.
May identify primary diabetes discharges for targeted readmission prevention; leaves open independent causality after adjustment.
Hospital readmission among people with diabetes is common and costly. A better understanding of the differences between people requiring hospitalization primarily for diabetes (primary discharge diagnosis, 1°DCDx) or another condition (secondary discharge diagnosis, 2°DCDx) may translate into more effective ways to prevent readmissions. This retrospective cohort study compared readmission risk and risk factors between 8054 hospitalized adults with a 1°DCDx or 2°DCDx. The primary outcome was all-cause hospital readmission within 30 days of discharge. The readmission rate was higher in patients with a 1°DCDx than in patients with a 2°DCDx (22.2% vs. 16.2%, p < 0.01). Several independent risk factors for readmission were common to both groups including outpatient follow up, length of stay, employment status, anemia, and lack of insurance. C-statistics for the multivariable models of readmission were not significantly different (0.837 vs. 0.822, p = 0.15). Readmission risk of people with a 1°DCDx was higher than that of people with a 2°DCDx of diabetes. Some risk factors were shared between the two groups, while others were unique. Inpatient diabetes consultation may be more effective at lowering readmission risk among people with a 1°DCDx. These models may perform well to predict readmission risk.
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Rubin et al. (2023) conducted a cohort in Diabetes (n=8,054). Primary discharge diagnosis of diabetes vs. Secondary discharge diagnosis of diabetes was evaluated on All-cause hospital readmission within 30 days of discharge (p=< 0.01). A primary discharge diagnosis of diabetes was associated with a higher 30-day all-cause hospital readmission rate compared to a secondary diagnosis (22.2% vs. 16.2%, p < 0.01).
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