IMPACT OF ENDOCRINE AND DIABETES TEAM CONSULTATION ON HOSPITAL LENGTHOF STAY FOR PATIENTS WITH DIABETES

PURPOSE: TO determine whether consultation by an individual endocrinol ogist or by a multidisciplinary diabetes team (endocrinologist, diabet es nurse educator, and registered dietitian) can impact length of hosp ital stay of patients with diabetes. PATIENTS AND METHODS: Hospital st ays of consecutive patients with a principal diagnosis of diabetes wer e compared. Forty-three patients were seen by an individual endocrine consultant and 27 were managed by the internist alone. Thirty-four pat ients were seen in consultation by the diabetes team. All consultation s were performed at the request of the primary physician. There were n o statistically significant differences among groups with respect to a ge, duration of diabetes, admitting diagnosis, glucose levels, or conc omitant acute or chronic illness. RESULTS: average length of stay of d iabetes-team patients was 3.6 +/- 1.7 days, 56% shorter than the value , 8.2 +/- 6.2 days, of patients in the no-consultation group (P <0.000 1), and 35% shorter than the value, 5.5 +/- 3.4 days, of patients who received a traditional individual endocrine consultation (P <0.05). Th e length of stay correlated with time from admission to consultation ( regression equation: y = 3.92 + [1.09 x time to consultation]; r = .55 ; P <0.0001). The slope (1.09) indicates that each 1-day delay in cons ultation resulted in a I-day increase in length of stay. CONCLUSIONS: Length of stay was lowest in patients who received diabetes-team consu ltation. Three million Americans are hospitalized annually with diabet es at a cost of $65 billion. A team approach to their inpatient care m ay reduce their hospital stays, resulting in considerable health and e conomic benefits.