11.2.0.0 Pre­vent­ing Read­mis­sions

In pa­tients with di­a­betes, the hos­pi­tal read­mis­sion rate is be­tween 14 and 20% (86). Risk fac­tors for read­mis­sion in­clude lower so­cioe­co­nom­ic sta­tus, cer­tain racial/‍ethnic mi­nor­i­ty groups, co­mor­bidi­ties, ur­gent ad­mis­sion, and re­cent prior hos­pi­talization (86). Of in­ter­est, 30% of pa­tients with two or more hos­pi­tal stays ac­count for over 50% of hos­pi­talizations and their ac­com­pa­ny­ing hos­pi­tal costs (87). While there is no stan­dard to pre­vent read­mis­sions, sev­er­al suc­cess­ful strate­gies have been re­port­ed, in­clud­ing an in­ter­ven­tion pro­gram tar­geting ke­to­sisprone pa­tients with type 1 di­a­betes (88), ini­ti­at­ing in­sulin treat­ment in pa­tients with ad­mis­sion A1C >9% (75 mmol/‍mol) (89), and a tran­si­tional care model (90). For peo­ple with di­a­bet­ic kid­ney dis­ease, pa­tient-centered med­i­cal home col­lab­o­ra­tives may de­crease risk-‍ad­just­ed read­mis­sion rates (91).