Khan Sara Atiq, Zilbermint Mihail
Division of Endocrinology, Diabetes, and Metabolism, University of Maryland School of Medicine, Baltimore, MD.
Division of Hospital Medicine, Johns Hopkins Community Physicians, Baltimore, MD.
Diabetes Spectr. 2022 Fall;35(4):391-397. doi: 10.2337/dsi22-0008. Epub 2022 Nov 15.
Poor inpatient glycemic management is associated with increased lengths of stay and in-hospital morbidity and mortality. Improving inpatient glycemic outcomes can be difficult because there are no standardized benchmarks, and many hospitals lack the capacity to electronically extract and analyze glucose data. The Centers for Medicare & Medicaid Services recently proposed new electronic clinical quality measures to be incorporated into its mandatory Hospital Inpatient Quality Reporting Program. Among these measures is an assessment of hospital harm from severe hypoglycemia and severe hyperglycemia. Hospitals must be ready to collect the necessary data for these new measures by January 2023. The new measures could bring welcome attention to the need to implement guideline-based inpatient glycemic management. However, some hospitals that serve high-risk populations may be at risk for losing funding if they are unable to comply.
住院患者血糖管理不善与住院时间延长、院内发病率和死亡率增加有关。改善住院患者的血糖结局可能很困难,因为没有标准化的基准,而且许多医院缺乏电子提取和分析血糖数据的能力。医疗保险和医疗补助服务中心最近提出了新的电子临床质量指标,将纳入其强制性的医院住院质量报告计划。这些指标中包括对严重低血糖和严重高血糖造成的医院伤害的评估。医院必须在2023年1月前准备好收集这些新指标所需的数据。这些新指标可能会引起人们对实施基于指南的住院患者血糖管理必要性的关注。然而,一些为高危人群服务的医院如果无法达标,可能面临失去资金的风险。