ODP216 Interventional Study To Reduce The Readmission Rate In Type 1 Diabetics Hospitalized For Diabetic Ketoacidosis

INTRODUCTION: Diabetic ketoacidosis (DKA) is an emergency associated with a high mortality rate. 25% of DKA readmissions in the U. S. A are preventable and they lead to an increase in the mortality rate and the length of the hospital stay with each new admission. In our study, we set out to decrease the DKA readmission rate at our hospital which is a community teaching hospital by assessing the predictors of readmission in adults with type 1 diabetics hospitalized for DKA. METHODS: The study was an interventional study conducted between February 2021 and May 2021. All the type 1 diabetics who were on insulin and had DKA admissions in the past three months were included in the study. After a literature review of the risk factors of DKA readmission, a questionnaire was designed to gather information from the patients. The ABCD (A: age; B: behavioral health; C: coverage; D: drug/alcohol abuse) score was used for DKA readmission risk assessment on admission. The insulin delivery technique of the patients was assessed and proper training on the technique was given before discharge. All the DKA admissions received mandatory endocrinology consult and the note template of the endocrinology consult note in the electronic medical record system was modified to let the primary team know about the discharge instructions, medications, and follow-up appointments in detail. Patients were followed up with a telehealth visit in a week and physical endocrinology clinic follow-up 3 weeks after discharge. RESULTS: Our study included 69 patients admitted with a diagnosis of DKA. The average HbA1C in the study was 11.8. Predictors of readmission were female sex (Hazard Ratio [HR]: 1.74, 95% CI: 1.64 - 1.80, p<0. 001), hypertension (HR: 1.98, 95% CI: 1.80 - 1.95, p<0. 001), discharge against medical advice (HR: 1.74, 95% CI: 1.53 - 1.96, p<0. 001). The readmission rate at the hospital was 20.8% initially and dropped to 13.7% after the interventions. 78% of the population were administering insulin the wrong way. The 'ABCD' score of the patients had a statistically significant correlation with the readmission rate. A difference in difference study model was used to assess the significance of the interventions on the readmission rate. Linear regression was run with significant R square, F- test values. CONCLUSIONS: The study revealed that the major risk factors for readmission were lower socioeconomic status, co-morbidities, poor health literacy, and drug abuse. The study highlighted the importance of inpatient education, specialty care, better discharge instructions, coordination of care, and post-discharge support to reduce the DKA readmission rate. Presentation: No date and time listed