Key result
New transition of care protocol targets 30-day ED visits in Hispanic adults with diabetes.
Why the study?
Hispanic/Latino adults with diabetes have higher risk of readmission and ED visits, and an optimal transition of care approach for ethnic/minority patients remains unclear.
Does a newly designed transition of care model reduce emergency department visits within 30 days post-discharge in Hispanic/Latino adults with diabetes?
Does a newly designed transition of care model reduce emergency department visits within 30 days post-discharge in Hispanic/Latino adults with diabetes?
This paper describes the design and rationale for a pilot study evaluating a transition of care model aimed at reducing 30-day emergency department visits and readmissions among Hispanic/Latino adults with diabetes.
Tests feasibility of transition-of-care model in Hispanic/Latino adults with diabetes; leaves open reduction in 30-day ED visits or readmissions.
BACKGROUND: The Hispanic/Latino population is disproportionately affected and has a higher risk of developing diabetes than their non-Hispanic White counterparts and worse diabetes-related outcomes. Diabetes continues to be an economic burden. This economic burden is partially due to the significantly higher rates of hospital readmission for individuals with diabetes. People with diabetes, particularly those who are members of racial/ethnic minority groups, are at higher risk for readmission and emergency department (ED) visits. Despite recommendations regarding transition of care, an optimal approach to the transition of care for ethnic/minority patients remains unclear. METHODS: The study population includes self-identified Hispanic/Latino adults with diabetes. We have two aims: (1) designed and developed a transition of care model and (2) pilot test the newly developed transition of care model. For aim 1, semi-structures interviews conducted with patients and providers. For aim 2, patients admitted to the hospital enrolled to receive the newly designed transition of care model. For aim 1, patients and providers completed a short questionnaire. For aim 2, patients completed a set of questionnaires including demographic information, medical history, sociocultural, and social support. The primary outcome for aim 2 is emergency department visit within 30 days post-discharge. The secondary outcome is 30- days unplanned readmissions. Feasibility outcomes include the number of participants identified, number of patients enrolled, number of participants who completed all the questionnaires, number of participants with a 30-day follow-up call, and number of participants who completed the 30-day post-discharge questionnaire. Due to the COVID-19 pandemic, the study design was adapted to include the Plan-Do-Study-Act framework to adjust to the ongoing changes in transition of care due to the pandemic burden on the health care systems. CONCLUSION: Transition of care for Hispanic/Latino patients with diabetes remains a major area of interest that requires further research. The pandemic required that we adapted the study to reflect the realities of health care systems during a time of crisis. The methods share in this manuscript can potentially help other investigators as they designed their studies. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT04864639. 4/29/2021. https://clinicaltrials.gov/ct2/show/NCT04864639 .
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Corsino et al. (2022) studied Diabetes (n=32). Culturally adapted transition of care model vs. Usual transition of care was evaluated on Emergency department visit within 30 days post-discharge. This paper is a study protocol describing the design of a pilot study to evaluate a new transition of care model for Hispanic/Latino adults with diabetes, and therefore contains no clinical results.
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