Korean J Adult Nurs.  2017 Feb;29(1):1-11. 10.7475/kjan.2017.29.1.1.

Factors associated with Hospitalization among Patients with Diabetes Mellitus

• Guk MR
• Choi JY

• KMID: 2406331
• DOI: http://doi.org/10.7475/kjan.2017.29.1.1

Abstract

PURPOSE
The purpose of this study was to identify the factors and the relative risk associated with admission of patients with diabetes mellitus (DM).
METHODS
The sample included one hundred twenty-eight patients with type II DM. Seventy-seven patients who were admitted within six months of a hospitalization to one hospital from the first of February to the 31st of August 2014, were compared with fifty-one patients who regularly attended an outpatient clinic and had no hospitalizations.
RESULTS
Hospitalization probabilities among patients who had only diet and exercise or took oral diabetic medication were 0.03 (p=.004) and 0.21 (p=.007) times independently lower than the ones with insulin injection. The risks for hospitalization increases 6.33 times if there is absence of a spouse (p=.027) whereas the presence of a spouse seems to make hospitalization less likely. The risk among the ones having diabetic complications was 5.15 times higher than ones having no recognition of the complications (p=.040). For every one point increase in self-efficacy and every 1 mg/dL increase in high density lipoprotein (HDL) cholesterol, there was a 0.84 (p=.005) and a 0.96 (p=.036) decrease in hospitalization risk, respectively.
CONCLUSION
Nurses should be sensitive to the risk groups of hospital admission among patients with DM including no spouse, insulin injection, diabetic complications, low self-efficacy, and low HDL cholesterol.

MeSH Terms

Ambulatory Care Facilities
Cholesterol
Cholesterol, HDL
Diabetes Complications
Diabetes Mellitus*
Diet
Hospitalization*
Humans
Insulin
Lipoproteins
Patient Admission
Spouses
Cholesterol
Cholesterol, HDL
Insulin
Lipoproteins

Reference

1. Korean Diabetes Association. Diabetes Fact Sheet Korea 2012. Seoul: Korean Diabetes Association;2012.

2. National Health Insurance Service. Health Insurance review & Assessment Service. National health insurance statistical yearbook [Internet]. Seoul: National Health Insurance Service;2014. cited 2014 September 29. Available from: http://www.nhis.or.kr/bbs7/boards/B0075/12434.

3. Kang HJ, Ha SI, Lee SK, Kim SY, Hong JS, Lee KS. 2015 Korea healthcare quality report: achievements and challenges of Korea health care system. Health Hazard Evaluation Report. Sejong, Korea: Korea Institute for Health and Social Affairs;2015. 12. Report No.: 2015-05.

4. Kim J, Kim HY, Kim HwY, Min KW, Park SW, Park IB, et al. Current status of the continuity of ambulatory diabetes care and its impact on health outcomes and medical cost in Korea using national health insurance database. J Korean Diabetes Assoc. 2006; 30(5):377–387. DOI: 10.4093/jkda.2006.30.5.377.

5. Lim JH, Oh CS. Medical care utilization status and quality of life in diabetes mellitus patients. Journal of Digital Convergence. 2013; 11(10):609–618.

6. Seo HJ, Jung MS, Park GH. Diabetic knowledge, perceived stress, response patterns of health locus of control and sick-role behavior compliance in diabetic patients. J Kyungpook Nurs Sci. 2003; 7(2):1–18.

7. Jang SM, Han IY. Psycho-social variables affecting the diabetes self-care of male diabetic patients. Korean J Health Promot Dis Prev. 2004; 4(4):223–232.

8. Zhang HL, Kim HL. Compliance and barriers to self-care behaviors in patients with type 2 diabetes. J Korean Clin Nurs Res. 2010; 16(1):155–166.

9. Kang HY, Gu MO. Development and effects of a motivational interviewing self-management program for elderly patients with diabetes mellitus. J Korean Acad Nurs. 2015; 45(4):533–543. DOI: 10.4040/jkan.2015.45.4.533.

10. Moon SH, Lee YH, Ham OK, Kim SH. The effect of the experience of diabetes education on knowledge, self-care behavior and glycosylated hemoglobin in type 2 diabetic patients. J Korean Acad Soc Nurs Educ. 2014; 20(1):81–92. DOI: 10.5977/jkasne.2014.20.1.81.

11. Korean Academy of Medical Sciences and Centers for Disease Control and Prevention. Diabetes mellitus manual [Internet]. Seoul: Korean Academy of Medical Sciences;2016. cited 2016 October 2. Available from: http://www.kams.or.kr. http://www.guideline.or.kr.

12. Seo S, Han SH, Park YJ. The impact of diabetes fear of self-injecting (FSI) and fear of self-testing (FST) on glycemic control and diabetes self-management. J Korean Acad Fam Med. 2008; 29(10):768–780.

13. Sohn NY, Yang JH. Factors influencing self - care behaviors related to insulin therapy in elders with diabetes mellitus. J Korean Acad Fundam Nurs. 2013; 20(1):27–36. DOI: 10.7739/jkafn.2013.20.1.27.

14. Hsieh FY, Bloch DA, Larsen MD. A simple method of sample size calculation for linear and logistic regression. Stat Med. 1998; 17:1623–1634.

15. Stuart L, Wiles PG. A comparison of qualitative and quantitative research methods used to assess knowledge of foot care among people with diabetes. Diabet Med. 1997; 14(9):785–791. https://doi.org/10.1002/(SICI)1096-9136(199709)14:9<785::AID-DIA466>3.0.CO;2-0.

16. Lee MS, Park KS. The effects of foot care education on knowledge and self-care behaviour diabetes mellitus. Chung-Ang J Nurs. 2001; 5(2):125–131.

17. Hurley AC. Measuring self care ability in patients with diabetes: the insulin management diabetes self-efficacy scale. In : Strickland OL, Waltz CF, editors. Measurement of nursing outcomes. 4th ed. New York: Springer Publishing Co;1988.

18. Cho YI. A structural model for health promotion behaviors and the quality of life of patients with type 2 diabetes mellitus. [dissertation]. Seoul: Kyung Hee University;2004.

19. Toobert DJ, Glasgow RE. Assessing diabetes self-management: the summary of diabetes self-care activities questionnaire. In : Bradley C, editor. In Handbook of Psychology and Diabetes. Chur, Switzerland: Harwood Academic;1994. p. 351–375.

20. Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000; 23(7):943–950. DOI: 10.2337/diacare.23.7.943.

21. Park OJ. The effect of social support on compliance with sick-role behavior in diabetic patients. J Korean Diabetes Assoc. 1985; 9(2):276–277.

22. Polonsky WH, Fisher L, Earles J, Dudl RJ, Lees J, Mullan J, et al. Assessing psychosocial distress in diabetes. Diabetes Care. 2005; 28(3):626–631. DOI: 10.2337/diacare.28.3.626.

23. Choi EJ. Factors related to glycemic control in patients with type 2 diabetes mellitus. [dissertation]. Seoul: Yonsei University;2007.

24. Cho KH. The association between continuity of ambulatory care and hospital admission in the patients of type 2 diabetes mellitus. [master's thesis]. Seoul: Yonsei University;2013.

25. Levin P, Zhou S, Durden E, Farr AM, Gill J, Wei W. Clinical and economic outcomes associated with the timing of initiation of basal insulin in patients with type 2 diabetes mellitus previously treated with oral antidiabetes drugs. Clin Ther. 2016; 38(1):110–121. DOI: 10.1016/j.clinthera.2015.11.011.

26. Laires PA, Conceição J, Araújo F, Dores J, Silva C, Radican L, et al. The cost of managing severe hypoglycemic episodes in type 2 diabetic patients. Expert Rev Pharmacoecon Outcomes Res. 2016; 16(2):315–325. DOI: 10.1586/14737167.2015.1084230.

27. Lee BC, Choi KJ, Sun ML. Factors associated with early revisits and hospitalization after a revisit to the emergency department in elderly patients. J Korean Geriatr Soc. 2010; 14(2):77–83. DOI: 10.4235/jkgs.2010.14.2.77.

28. Kang KJ, Yu SJ, Seo HM, Yu M, Park MS, Jang HC. Factors influencing self management behavior for patients with type 2 diabetes: comparison of difference between the elderly and adults. J Korean Biol Nurs Sci. 2012; 14(2):112–121. DOI: 10.7586/jkbns.2012.14.2.112.

29. Mahmoodpoor A, Hamishehkar H, Shadvar K, Beigmohammadi M, Iranpour A, Sanaie S. Relationship between glycated hemoglobin, intensive care unit admission blood sugar and glucose control with ICU mortality in critically ill patients. Indian J Crit Care Med. 2016; 20(2):67–71. DOI: 10.4103/0972-5229.175938.

30. Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003; 79(12):1471–1478. DOI: 10.4065/78.12.1471.