Changes in hospital admissions and inpatient tariff associated with a Diabetes Integrated Care Initiative: Preliminary findings (与糖尿病综合护理计划相关的住院以及住院费用的变化：初步调查结果)

Abstract Background The D iabetes I ntegrated C are Initiative ( DICI ) has tested whether hospital admissions and total amounts paid for inpatient care have declined through closer (integrated) working between primary, secondary and community diabetes services in C ambridgeshire.Method Poisson regression models were used to compare the percentage change in hospital admissions, and tariff paid, before and after each of 43 months ( A pril 2007 – N ovember 2010). East C ambridgeshire and F enland ( ECF ) practices were divided into those fully ( n  = 10) and less ( n  = 7) “engaged” with the intervention defined by the extent of their uptake of intervention components between J uly 2009 and J une 2010. Other parts of the county were “controls”.Results Among patients with diabetes in the fully engaged ECF practices, the monthly average hospital admission rate was 19.0% (13.9, 24.2) higher (7.7 hospital admissions per 1000 patients) and the monthly tariff paid was 28.8% (28.7, 28.9) higher (£19.60 per patient per month), at the time of introducing the DICI versus the pre‐implementation period ( A pril 2007 to J une 2009). These differences, had dropped to 8.7% (1.9, 15.6) and 13.4% (13.2, 13.5) (£9.92 per patient per month) higher 12 months after introduction. Comparable reductions in the rate of increase were not seen among those without diabetes or in control areas.Conclusion During the DICI , patients with diabetes from “fully engaged” practices experienced increased hospitalization and amount paid for in‐patient care, the extent of which trended downwards by 12 months. Further time is needed to monitor whether this trend is sustained.