HOSPITAL MANAGEMENT OF DIABETES (GE UMPIERREZ, SECTION EDITOR)
Hospital Readmission of Patients with Diabetes
Daniel J. Rubin
Published online: 25 February 2015
Springer Science+Business Media New York 2015
Abstract Hospital readmission is a high-priority health care
quality measure and target for cost reduction. Despite broad
interest in readmission, relatively little research has focused on
patients with diabetes. The burden of diabetes among hospital-
ized patients, however, is substantial, growing, and costly, and
readmissions contribute a significant portion of this burden.
Reducing readmission rates of diabetic patients has the poten-
tial to greatly reduce health care costs while simultaneously
improving care. Risk factors for readmission in this population
include lower socioeconomic status, racial/ethnic minority, co-
morbidity burden, public insurance, emergent or urgent admis-
sion, and a history of recent prior hospitalization. Hospitalized
patients with diabetes may be at higher risk of readmission than
those without diabetes. Potential ways to reduce readmission
risk are inpatient education, specialty care, better discharge
instructions, coordination of care, and post-discharge support.
More studies are needed to test the effect of these interventions
on the readmission rates of patients with diabetes.
Keywords Hospital readmission
Transitions of care
Hospital readmission is a high-priority health care qual-
ity measure and target for cost reduction, particularly
within 30 days of discharge (30-day readmission, aka
early readmission) [1–3]. Despite the broad interest in
readmission, relatively little research has focused specif-
ically on readmission of patients with diabetes [4–6].
The burden of diabetes among hospitalized patients,
however, is substantial, growing, and costly, and
readmissions contribute a significant portion of this bur-
den. Reducing readmission rates among patients with
diabetes has the potential to greatly reduce health care
costs while simultaneously improving care. Recent re-
search has provided some insight into the risk factors
for readmission and the barriers to reducing readmission
risk, as well as ways to mitigate that risk.
Why Should We Care About Readmission
Among Diabetic Patients?
Many believe readmission rates reflect the quality of
health care delivery, although this is debated .
Starting October 1, 2012, the Centers for Medicare
and Medicaid Services began to decrease payments to
hospitals that have greater-than-expected 30-day read-
mission rates under the Hospital Readmission Reduction
Program established by the Patient Protection and Af-
fordable Care Act, reflecting an effort to motivate im-
provements in care while reducing costs . In the cur-
rent era of major health care reform, there is growing
interest in hospital readmissions. There has been an ex-
ponential rise in the past decade of PubMed-cited arti-
cles published in this area, from less than 100 annually
in the 1980s to 1379 in 2013 .
Despite interest in readmissions, few studies have focused
on readmissions among patients with diabetes [4–6]. There
were only 85 publications listed on PubMed containing the
search terms Bhospital, readmission, and diabetes^ in 2013 ,
This article is part of the Topical Collection on Hospital Management of
D. J. Rubin (*)
Section of Endocrinology, Diabetes, and Metabolism, School of
Medicine, Temple University, 3322 N. Broad ST., Ste 205,
Philadelphia, PA 19140, USA
Curr Diab Rep (2015) 15: 17