JANUARY 15, 2019
At a Cost of $10,405 Per Patient Stay, Hypoglycemia in The Hospital Cannot Be Ignored
A diabetes webinar hosted by the American Hospital Association and sponsored by Glytec showcased why hypoglycemia prevention is imperative to the safety of patients and to the economics of healthcare delivery.
Waltham, MA — Featured speakers, Dr. Richard Pratley of Florida Hospital System and Dr. Steven Edelman of UC San Diego Health, recently delivered a unified message to several hundred senior healthcare professionals attending an American Hospital Association webinar: Hypoglycemia [low blood sugar] in the hospital is a major patient safety risk with significant clinical and financial implications. A case study presented by Pratley further revealed that insulin-managed patients who experience severe hypoglycemia, or blood sugar less than 40 mg/dL, have longer stays, higher readmission and mortality rates, and an overall cost of care $10,405 greater than patients whose blood sugar remains in the normal range.
Florida Hospital System Case Study*
|Outcome||Normal Glycemia||Severe Hypoglycemia||Difference|
|Average LOS||7.8 Days||14.4 Days||6.6 Days (84.6% Higher)|
|Readmission Rate||13.5%||21.8%||8.3% Absolute (61.5% Higher)|
|Mortality Rate||3.2%||9.2%||6.0% Absolute (187.5% Higher)|
|Average Cost Per Stay||$11,039||$21,444||$10,405 (94.3% Higher)|
*The Florida Hospital System case study examined data for 43,659 patients over a 12-month period in 2015-2016. The results presented during the webinar were also presented in poster form at the 30th Annual IHI National Forum on Quality Improvement in Health Care.
View the recorded webinar and download the slide deck here.
Both Pratley and Edelman are regarded as thought leaders in the diabetes space and have authored several hundred peer-reviewed articles. Pratley currently serves as Associate Medical Director of Research and Education at the Florida Hospital Diabetes Institute; Senior Investigator and Diabetes Program Lead at the Translational Research Institute for Metabolism and Diabetes; and an adjunct professor at Sanford Burnham Prebys Medical Discovery Institute. Edelman is Director of the Diabetes Care Clinic at VA San Diego Healthcare System; Founder and Director of Taking Control of Your Diabetes 501 (c)3; and a professor of medicine at University of California San Diego.
The webinar, Improving the Quality and Cost of Diabetes Care: How Florida Hospital System Discovered and Reduced Hypoglycemia Risks, showcased the relationship between insulin and hypoglycemia, and the benefits of systemization, standardization and personalization of care. Edelman reinforced some of the most telling national statistics regarding insulin: 50% of medication errors involve insulin, including one-third of all that are fatal; use of insulin and other hypoglycemia agents are associated with 57% of adverse drug events; and approximately one-quarter of all safety incidents involving insulin result in patient harm.**
“Insulin is the standard of care for achieving blood glucose control in the hospital, but it is very tough to manage, especially in patients whose metabolic and medical status is changing over time,” said Edelman. “This is a SERIOUS issue, and because this is such a serious issue, CMS is developing a hypoglycemia measure and they’re going to hold hospitals accountable.” When asked for his thoughts on the first line of defense against hypoglycemia given so few endocrinologists in our hospitals, Edelman replied: “I have a bias toward using technology. Yes, with technology comes a whole level of education, but I can tell you, once you put in a little time and effort, the system is extremely impressive and can help patients get through the hospital and avoid adverse events and get them out of the hospital in a timely manner.”
Pratley revealed that Florida Hospital System and its parent, AdventHealth (formerly known as Adventist Health System) adopted Glytec’s eGlycemic Management System® to provide enterprise-wide decision support for insulin therapy optimization. The health system has subsequently reduced severe hypoglycemia 40% to 95% (patient days) compared to paper protocols.
Pratley also reminded the audience that at any time, about 30% of all hospitalized patients have diabetes, and therefore, this is a problem that is not going away. “Diabetes management in the hospital is not a set-it-and-forget-it strategy, it needs to be personalized,” Pratley emphasized. “It is perhaps the ultimate in a patient-centered approach.”
Pratley closed his remarks with a call to action: “There are lots of priorities in the hospital, but this is clearly one that affects a large number of patients, it’s clearly one where there’s a large number of adverse events associated with treatment, and is clearly one where we can do better and we have the tools to do better!”
- The United States Pharmacopeial Convention, National Coordinating Council for Medication Error Reporting and Prevention. Institute for Safe Medication Practices Medication Errors Reporting Program.
- Hellman R. A systems approach to reducing errors in insulin therapy in the inpatient setting. Endocr Pract. 2004 Mar-Apr; 10 Suppl 2:100-8.
- Classen DC, Jaser L, Budnitz DS. Adverse drug events among hospitalized Medicare patients: epidemiology and national estimates from a new approach to surveillance. Jt Comm J Qual Patient Saf. 2010 Jan;36(1):12-21.
- Cousins D, Rosario C, Scarpello J. Insulin, hospitals and harm: a review of patient safety incidents reported to the National Patient Safety Agency. Clin Med (Lond). 2011 Feb;11(1):28-30.
Glytec is the pioneer of personalized digital therapeutics, enabling best practices for insulin optimization across the continuum of care. The company’s patented and FDA-cleared software-as-a-medical-device solutions improve the safety and health of people with diabetes in the hospital and at home. Glytec combines evidence-based decision support technologies with expert clinical services to make insulin a more effective medication option for the millions unable to achieve their treatment goals, leading to reductions in A1C, hypoglycemia and other complications as well as avoidable ED visits, hospitalizations, readmissions and drug waste. The company has offices in Waltham, Massachusetts and Greenville, South Carolina. For more information visit www.glytecsystems.com.