Wiley Kevin, Blackburn Justin, Mendonca Eneida, Menachemi Nir, De Groot Mary, Vest Joshua R
Department of Healthcare Leadership and Management, Medical University of South Carolina (MUSC), 151-B Rutledge Avenue, Charleston, SC USA.
Department of Health Policy and Management Richard M. Fairbanks School of Public Health, Indiana University Indianapolis, Indianapolis, IN USA.
J Diabetes Metab Disord. 2023 Jul 1;22(2):1319-1326. doi: 10.1007/s40200-023-01250-0. eCollection 2023 Dec.
To examine the longitudinal relationship between the age or shelf-life of common type 2 diabetes laboratory tests for serum creatinine, cholesterol, and glycated hemoglobin A1c conducted in outpatient settings and subsequent inpatient hospitalizations and emergency department visits.
This study analyzes panel data from two healthcare delivery systems' electronic health records (EHR) for patients aged 18 years and older managing type 2 diabetes. We used EHR data to quantify the age of three laboratory tests: serum creatinine, cholesterol, and glycated hemoglobin A1c. Encounter data were used to determine the frequency of inpatient hospitalizations and emergency department visits. Negative binomial regressions with fixed effects were performed to compute marginal effects, levels of statistical significance, and 95% confidence intervals.
The average age for serum creatinine laboratory tests was 1.51 months (95%CI: 1.49-1.53). We computed older average ages for hemoglobin A1c (mean:6.17 months; 95%CI: 6.11-6.23) and serum creatinine tests (mean: 8.73; 95%CI: 8.65-8.81). Older laboratory tests were associated with an increase in the total expected counts of subsequent inpatient hospitalizations (ME = 0.047; p < 0.001) and ED visits (ME = 0.034; p < 0.001).
Findings from this study indicate that older type 2 diabetes laboratory tests are associated with increases in the total expected count of subsequent inpatient hospitalizations and emergency department visits. Future research should examine the actionability of laboratory test values to determine associations with healthcare outcomes.
The online version contains supplementary material available at 10.1007/s40200-023-01250-0.
研究门诊环境中进行的血清肌酐、胆固醇和糖化血红蛋白A1c等常见2型糖尿病实验室检测的年龄或保存期限与随后的住院治疗和急诊就诊之间的纵向关系。
本研究分析了两个医疗服务系统中18岁及以上2型糖尿病患者电子健康记录（EHR）中的面板数据。我们使用EHR数据来量化三项实验室检测的时间：血清肌酐、胆固醇和糖化血红蛋白A1c。就诊数据用于确定住院治疗和急诊就诊的频率。进行了固定效应负二项回归，以计算边际效应、统计显著性水平和95%置信区间。
血清肌酐实验室检测的平均时间为1.51个月（95%CI：1.49 - 1.53）。我们计算出糖化血红蛋白A1c检测的平均时间更长（均值：6.17个月；95%CI：6.11 - 6.23），血清胆固醇检测的平均时间也更长（均值：8.73；95%CI：8.65 - 8.81）。检测时间越长，随后住院治疗的总预期次数增加（ME = 0.047；p < 0.001），急诊就诊次数也增加（ME = 0.034；p < 0.001）。
本研究结果表明，2型糖尿病实验室检测时间越长，随后住院治疗和急诊就诊的总预期次数增加。未来的研究应检验实验室检测值的可操作性，以确定与医疗结果的关联。
在线版本包含可在10.1007/s40200-023-01250-0获取的补充材料。
