Impact of endocrine and diabetes team consultation on hospital length of stay for patients with diabetes

PURPOSE : To determine whether consultation by an individual endocrinologist or by a multidisciplinary diabetes team (endocrinologist, diabetes nurse educator, and registered dietitian) can impact length of hospital stay of patients with diabetes. PATIENTS AND METHODS : Hospital stays of consecutive patients with a principal diagnosis of diabetes were compared. Forty-three patients were seen by an individual endocrine consultant and 27 were managed by the internist alone. Thirty-four patients were seen in consultation by the diabetes team. All consultations were performed at the request of the primary physician. There were no statistically significant differences among groups with respect to age, duration of diabetes, admitting diagnosis, glucose levels, or concomitant acute or chronic illness. RESULTS : Average length of stay of diabetes-team patients was 3.6 ± 1.7 days, 56% shorter than the value, 8.2 ± 6.2 days, of patients in the noconsultation group (P <0.0001), and 35% shorter than the value, 5.5 ± 3.4 days, of patients who received a traditional individual endocrine consultation (P <0.05). The length of stay correlated with time from admission to consultation (regression equation : y = 3.92 x [1.09 x time to consultation] ; r =.55 ; P <0.0001). The slope (1.09) indicates that each 1-day delay in consultation resulted in a 1-day increase in length of stay. CONCLUSIONS : Length of stay was lowest in patients who received diabetes-team consultation. Three million Americans are hospitalized annually with diabetes at a cost of $65 billion. A team approach to their inpatient care may reduce their hospital stays, resulting in considerable health and economic benefits.