Real-time support of pediatric diabetes self-care by a transport team

Brandi Franklin, S. Crile Crisler, Rebekah Shappley, Meri M. Armour, Dana T. McCommon, Robert J. Ferry

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective The study seeks to improve access for underserved patients via novel integration of Pedi-Flite (a critical care transport team) and to validate whether this safely enhances diabetes care and effectively expands the endocrine workforce. Research Design And Methods The study retrospectively analyzed pager service use in a cohort of established diabetic patients (n = 979) after inception of Pedi-Flite support. Outcomes included incidence and severity of recurrent diabetic ketoacidosis (DKA) and cost savings generated from reduced referrals to the emergency department (ED) and on-call endocrinologist. We generated descriptive statistics to characterize the study population and ED visits for DKA and constructed logistic regression models to examine associations of pager use and likelihood of ED visitation and nonelective inpatient admission from an ED for DKA. Results Pager users comprised 30% of the patient population. They were younger but had more established diabetes than nonusers. While pager users were 2.75 times more likely than nonusers to visit the ED for DKA (P 0.0001), their visits were less likely to lead to inpatient admissions (odds ratio 0.58; P 0.02). More than half (n = 587) of all calls to the pager were resolved without need for further referral. Estimates suggest that 439 ED visits and 115 admissions were avoided at a potential cost savings exceeding 760,000 USD. Conclusions Integration of a transport service provides a novel, cost-effective approach to reduce disparities in diabetes care. Advantages include scalability, applicability to other disease areas and settings, and low added costs. These findings enrich an emerging evidence base for telephonic care-management models supported by allied health personnel.

Original languageEnglish (US)
Pages (from-to)81-87
Number of pages7
JournalDiabetes care
Volume37
Issue number1
DOIs
StatePublished - Jan 1 2014

Fingerprint

Self Care
Hospital Emergency Service
Diabetic Ketoacidosis
Pediatrics
Cost Savings
Inpatients
Referral and Consultation
Logistic Models
Costs and Cost Analysis
Allied Health Personnel
Vulnerable Populations
Critical Care
Population
Research Design
Odds Ratio
Incidence

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Franklin, B., Crisler, S. C., Shappley, R., Armour, M. M., McCommon, D. T., & Ferry, R. J. (2014). Real-time support of pediatric diabetes self-care by a transport team. Diabetes care, 37(1), 81-87. https://doi.org/10.2337/dc13-1041

Real-time support of pediatric diabetes self-care by a transport team. / Franklin, Brandi; Crisler, S. Crile; Shappley, Rebekah; Armour, Meri M.; McCommon, Dana T.; Ferry, Robert J.

In: Diabetes care, Vol. 37, No. 1, 01.01.2014, p. 81-87.

Research output: Contribution to journalArticle

Franklin, B, Crisler, SC, Shappley, R, Armour, MM, McCommon, DT & Ferry, RJ 2014, 'Real-time support of pediatric diabetes self-care by a transport team', Diabetes care, vol. 37, no. 1, pp. 81-87. https://doi.org/10.2337/dc13-1041
Franklin B, Crisler SC, Shappley R, Armour MM, McCommon DT, Ferry RJ. Real-time support of pediatric diabetes self-care by a transport team. Diabetes care. 2014 Jan 1;37(1):81-87. https://doi.org/10.2337/dc13-1041
Franklin, Brandi ; Crisler, S. Crile ; Shappley, Rebekah ; Armour, Meri M. ; McCommon, Dana T. ; Ferry, Robert J. / Real-time support of pediatric diabetes self-care by a transport team. In: Diabetes care. 2014 ; Vol. 37, No. 1. pp. 81-87.
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