Angus, Val C. and Waugh, Norman. (2007) Hospital admission patterns subsequent to diagnosis of type 1 diabetes in children : a systematic review. BMC Health Services Research, Vol.7 (No.1). p. 199. ISSN 1472-6963

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Abstract

Background Patients with type 1 diabetes are known to have a higher hospital admission rate than the underlying population and may also be admitted for procedures that would normally be carried out on a day surgery basis for non-diabetics. Emergency admission rates have sometimes been used as indicators of quality of diabetes care. In preparation for a study of hospital admissions, a systematic review was carried out on hospital admissions for children diagnosed with type 1 diabetes, whilst under the age of 15. The main thrust of this review was to ascertain where there were gaps in the literature for studies investigating post-diagnosis hospitalisations, rather than to try to draw conclusions from the disparate data sets. Methods A systematic search of the electronic databases PubMed, Cochrane LibrarMEDLINE and EMBASE was conducted for the period 1986 to 2006, to identify publications relating to hospital admissions subsequent to the diagnosis of type 1 diabetes under the age of 15. Results Thirty-two publications met all inclusion criteria, 16 in Northern America, 11 in Europe and 5 in Australasia. Most of the studies selected were focussed on diabetic ketoacidosis (DKA) or diabetes-related hospital admissions and only four studies included data on all admissions. Admission rates with DKA as primary diagnosis varied widely between 0.01 to 0.18 per patient-year as did those for other diabetes-related co-morbidity ranging from 0.05 to 0.38 per patient year, making it difficult to interpret data from different study designs. However, people with Type 1 diabetes are three times more likely to be hospitalised than the non-diabetic populations and stay in hospital twice as long. Conclusion Few studies report on all admissions to hospital in patients diagnosed with type 1 diabetes whilst under the age of 15 years. Health care costs for type 1 patients are higher than those for the general population and information on associated patterns of hospitalisation might help to target interventions to reduce the cost of hospital admissions.

Item Type:	Journal Article
Subjects:	R Medicine > RJ Pediatrics
Divisions:	Faculty of Medicine > Warwick Medical School > Warwick Evidence Faculty of Medicine > Warwick Medical School > Health Sciences
Library of Congress Subject Headings (LCSH):	Diabetes in children -- Complications, Diabetics -- Hospital care
Journal or Publication Title:	BMC Health Services Research
Publisher:	Bio Med Central
ISSN:	1472-6963
Date:	2007
Volume:	Vol.7
Number:	No.1
Page Range:	p. 199
Identification Number:	10.1186/1472-6963-7-199
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
References:	1. [http://www.diabetes.niddk.nih.gov/dm/pubs/control/]. 2. Clar C, Waugh N, Thomas S: Routine hospital admission versus out-patient or home care in children at diagnosis of type 1 diabetes mellitus. Cochrane Database Syst Rev 2007:CD004099. 3. Royle P, Bain L, Waugh N: Systematic reviews of epidemiology in diabetes: finding the evidence. BMC medical research methodology 2005, 5(1):2. 4. Royle PL, Bain L, Waugh NR: Sources of evidence for systematic reviews of interventions in diabetes. Diabetic medicine : a journal of the British Diabetic Association 2005, 22(10):1386-1393. 5. Sutton DL, Greenacre P, Howard NJ, Cowell CT, Silink M: Patterns of hospitalisation in a paediatric diabetes clinic in Sydney. Diabetes research and clinical practice 1989, 7(4):271-276. 6. Moss SE, Klein R, Klein BE: Risk factors for hospitalization in people with diabetes. Archives of Internal Medicine 1999, 159(17):2053-2057. 7. Palta M, Shen G, Allen C, Klein R, D'Alessio D: Longitudinal patterns of glycemic control and diabetes care from diagnosis in a population-based cohort with type 1 diabetes. The Wisconsin Diabetes Registry. American Journal of Epidemiology 1996, 144(10):954-961. 8. Palta M, Lecaire T, Daniels K, Shen G, Allen C, D'Alessio D: Risk factors for hospitalization in a cohort with type 1 diabetes. Wisconsin Diabetes Registry. American Journal of Epidemiology 1997, 146(8):627-636. 9. O'Hara DA, McCarty D: Complications of diabetes in the hospitalized population in Victoria, 1993–95. Journal of quality in clinical practice 1998, 18(3):177-185. 10. Hirasing RA, Reeser HM, De Groot RR, Ruwaard D, Van Buuren S, Verloove-Vanhorick SP: Trends in hospital admissions among children aged 0–19 years with type I diabetes in The Netherlands. Diabetes care 1996, 19(5):431-434. 11. Charron-Prochownik D, Kovacs M, Obrosky DS, Stiffler L: Biomedical, psychosocial predictors of early rehospitalization among children with insulin-dependent diabetes mellitus: a longitudinal study. Diabetic medicine : a journal of the British Diabetic Association 1994, 11(4):372-377. 12. Tuomilehto J, Borch-Johnsen K, Molarius A, Jormanainen V, Lounamaa R, Gronhagen-Riska C, Reunanen A, Sarti C: The unchanging incidence of hospitalization for diabetic nephropathy in a population-based cohort of IDDM patients in Finland. Diabetes care 1997, 20(7):1081-1086. 13. Lipton RB, Zierold KM, Drum ML, Klein-Gitelman M, Kohrman AF: Re-hospitalization after diagnosis of diabetes varies by gender and socioeconomic status in urban African-American and Latino young people. Pediatr Diabetes 2002, 3(1):16-22. 14. Icks A, Rosenbauer J, Holl RW, Grabert M, Rathmann W, Giani G, German Working Group for Pediatric Diabetology: Hospitalization among diabetic children and adolescents and the general population in Germany. German Working Group for Pediatric Diabetology. Diabetes care 2001, 24(3):435-440. 15. Icks A, Rosenbauer J, Haastert B, Giani G: Hospitalization among diabetic children and adolescents and non-diabetic control subjects: a prospective population-based study. Diabetologia 2001, 44(Suppl 3):B87-92. 16. Donnan PT, Leese GP, Morris AD, Diabetes Audit and Research in Tayside, Scotland/Medicine Monitoring Unit Collaboration: Hospitalizations for people with type 1 and type 2 diabetes compared with the nondiabetic population of Tayside, Scotland: a retrospective cohort study of resource use. Diabetes care 2000, 23(12):1774-1779. 17. Tomlin AM, Tilyard MW, Dovey SM, Dawson AG: Hospital admissions in diabetic and non-diabetic patients : A case-control study. Diabetes research and clinical practice 2006, 73(3):260-267. 18. Cohn BA, Cirillo PM, Wingard DL, Austin DF, Roffers SD: Gender differences in hospitalizations for IDDM among adolescents in California, 1991. Implications for prevention. Diabetes care 1997, 20(11):1677-1682. 19. Roberts SE, Goldacre MJ, Neil HA: Mortality in young people admitted to hospital for diabetes: database study. BMJ (Clinical research ed.) 2004, 328(7442):741-742. 20. Curtis JR, To T, Muirhead S, Cummings E, Daneman D: Recent trends in hospitalization for diabetic ketoacidosis in ontario children. Diabetes care 2002, 25(9):1591-1596. 21. Bui TP, Werther GA, Cameron FJ: Trends in diabetic ketoacidosis in childhood and adolescence: a 15-yr experience. Pediatric diabetes 2002, 3(2):82-88. 22. Rosilio M, Cotton JB, Wieliczko MC, Gendrault B, Carel JC, Couvaras O, Ser N, Bougneres PF, Gillet P, Soskin S, Garandeau P, Stuckens C, Le Luyer B, Jos J, Bony-Trifunovic H, Bertrand AM, Leturcq F, Lafuma A: Factors associated with glycemic control. A cross-sectional nationwide study in 2,579 French children with type 1 diabetes. The French Pediatric Diabetes Group. Diabetes care 1998, 21(7):1146-1153. 23. Rewers A, Chase HP, Mackenzie T, Walravens P, Roback M, Rewers M, Hamman RF, Klingensmith G: Predictors of acute complications in children with type 1 diabetes. JAMA : the journal of the American Medical Association 2002, 287(19):2511-2518. 24. Keenan HT, Foster CM, Bratton SL: Social factors associated with prolonged hospitalization among diabetic children. Pediatrics 2002, 109(1):40-44. 25. Dunger DB, Sperling MA, Acerini CL, Bohn DJ, Daneman D, Danne T, Glaser NS, Hanas R, Hintz RL, Levitsky LL, Savage MO, Tasker RC, Wolfsdorf JI, ESPE and LWPES: ESPE/LWPES consensus statement on diabetic ketoacidosis in children and adolescents. Archives of Disease in Childhood 2004, 89(2):188-194. 26. Smith CP, Firth D, Bennett S, Howard C, Chisholm P: Ketoacidosis occurring in newly diagnosed and established diabetic children. Acta Paediatrica (Oslo, Norway : 1992) 1998, 87(5):537-541. 27. Morris AD, Boyle DI, Mcmahon AD, Greene SA, Macdonald TM, Newton RW: Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus. The DARTS/MEMO Collaboration. Diabetes Audit and Research in Tayside Scotland. Medicines Monitoring Unit. Lancet 1997, 350(9090):1505-1510. 28. Smaldone A, Honig J, Stone PW, Arons R, Weinger K: Characteristics of California children with single versus multiple diabetic ketoacidosis hospitalizations (1998–2000). Diabetes care 2005, 28(8):2082-2084. 29. Jiang HJ, Stryer D, Friedman B, Andrews R: Multiple hospitalizations for patients with diabetes. Diabetes care 2003, 26(5):1421-1426. 30. Kovacs M, Charron-Prochownik D, Obrosky DS: A longitudinal study of biomedical and psychosocial predictors of multiple hospitalizations among young people with insulin-dependent diabetes mellitus. Diabetic medicine : a journal of the British Diabetic Association 1995, 12(2):142-148. 31. Glasgow AM, Weissberg-Benchell J, Tynan WD, Epstein SF, Driscoll C, Turek J, Beliveau E: Readmissions of children with diabetes mellitus to a children's hospital. Pediatrics 1991, 88(1):98-104. 32. Swift PG, Hearnshaw JR, Botha JL, Wright G, Raymond NT, Jamieson KF: A decade of diabetes: keeping children out of hospital. BMJ (Clinical research ed.) 1993, 307(6896):96-98. 33. Laffel LM, Brackett J, Ho J, Anderson BJ: Changing the process of diabetes care improves metabolic outcomes and reduces hospitalizations. Quality management in health care 1998, 6(4):53-62. 34. Laffel LM, Wentzell K, Loughlin C, Tovar A, Moltz K, Brink S: Sick day management using blood 3-hydroxybutyrate (3-OHB) compared with urine ketone monitoring reduces hospital visits in young people with T1DM: a randomized clinical trial. Diabetic medicine : a journal of the British Diabetic Association 2006, 23(3):278-284. 35. Levine BS, Anderson BJ, Butler DA, Antisdel JE, Brackett J, Laffel LM: Predictors of glycemic control and short-term adverse outcomes in youth with type 1 diabetes. The Journal of pediatrics 2001, 139(2):197-203. 36. Svoren BM, Butler D, Levine BS, Anderson BJ, Laffel LM: Reducing acute adverse outcomes in youths with type 1 diabetes: a randomized, controlled trial. Pediatrics 2003, 112(4):914-922. 37. Robertshaw HJ, Hall GM: Diabetes mellitus: anaesthetic management. Anaesthesia 2006, 61(12):1187-1190. 38. British Association of Day Surgery: Day surgery & the diabetic patient – Guidelines for the assessment and management of diabetes in day surgery patients Norwich: Colman Print; 2004. 39. Williams DRR, Fuller JH, Stevens LK: Validity of routinely collected hospital admissions data on diabetes. Diabetic med 1989, 6:320-4. 40. Leslie PJ, Patrick AW, Hepburn DA, Scougal IJ, Frier BM: Hospital inpatient statistics under-estimate the morbidity associated with diabetes mellitus. Diabetic Med 1992, 9:379-385. 41. Wallymahmed ME, Dawes S, Clarke G, Saundrs S, Younis N, MacFarlane IA: Hospital in-patients with diabetes: increasing prevalence, management problems. Diabetic Med 2004, 22:107-9.
URI:	http://wrap.warwick.ac.uk/id/eprint/49876

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