Benchmarking Glycemic Control In U.S. Hospitals |
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| Affiliation: | 1. Division of Community Internal Medicine, Scottsdale, Arizona;2. Divisions of Endocrinology and Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Scottsdale, Arizona;3. The Epsilon Group, Charlottesville, Virginia.;4. Alere Informatics Solutions, Charlottesville, Virginia.;1. Emory University, Department of Medicine, Atlanta, GA, United States of America;2. Emory University, Department of Anesthesiology, United States of America;3. Emory Rollins School of Public Health, United States of America;1. Saint Vincent Charity Medical Center, Cleveland, Ohio;2. D.Y. Rowland Associates, Cleveland Heights, Ohio;3. Case Western Reserve University, Cleveland, Ohio.;1. Servicio de Medicina Interna, Hospital Universitario Fuenlabrada, Madrid, Spain;2. Servicio de Medicina Interna Hospital Regional Universitario Carlos Haya, Málaga, Spain;3. Servicio de Endocrinología, Hospital Universitario Fuenlabrada, Madrid, Spain;4. Servicio de Medicina Interna, Hospital Rey Juan Carlos, Móstoles;5. Servicio de Medicina Interna, Hospital Severo Ochoa, Leganés, Madrid, Spain;6. Servicio de Medicina Interna, Hospital Clínico Universitario San Carlos, Madrid, Spain.;1. Department of Endocrinology, Diabetes, and Metabolism, Cleveland, Ohio;2. Department of Radiation Oncology, Cleveland, Ohio;3. Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery and the Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio;4. Current Affiliation: Department of Neurosurgery, Geisinger Health System, Danville, Pennsylvania. |
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| Abstract: | ObjectiveReport data on glucose control from 635 U.S. hospitals.MethodsPoint-of-care blood glucose (POC-BG) test data from January through December 2012 from 635 facilities were extracted. Glucose control was evaluated using patient-day–weighted mean POC-BG values. We calculated hypoglycemia and hyperglycemia rates, stratified by presence or absence of intensive care unit (ICU) admission, and we evaluated the relationship between glycemic control and hospital characteristics.ResultsIn total, 51,375,764 POC-BG measurements (non-ICU, 39,197,762; ICU, 12,178,002) from 2,612,966 patients (non-ICU, 2,415,209; ICU, 575,084) were analyzed. The mean POC-BG was 167 mg/dL for non-ICU patients and 170 mg/dL for ICU patients. The prevalence of hyperglycemia (defined as glucose value > 180 mg/dL) was 32.3 and 28.2% in non-ICU and ICU patients, respectively. The prevalence of hypoglycemia (defined as glucose value < 70 mg/dL) was 6.1 and 5.6% in non-ICU and ICU patients, respectively. In non-ICU and ICU settings, the patient-day–weighted mean glucose was highest in the smallest hospitals, in rural hospitals, and in hospitals located in the Northeast (all P < .01). For non-ICU patients, we observed a significant difference in the percentage of patient days with hypoglycemia by geographic region only (P < .001). In ICU patients, the prevalence of hypoglycemia varied significantly by hospital type (P < .03) and geographic region (P < .01).ConclusionIn this largest POC-BG data set analysis conducted to date, glycemic control varied according to hospital characteristics. Our findings remain consistent with previous reports. Among other variables, national benchmarking of inpatient glucose data will need to consider differences in hospital characteristics. (Endocr Pract. 2014;20:876-883) |
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