Health Outcomes Research in Medicine
Volume 1, Issue 1 , Pages e61-e66, July 2010

The Effect of the Vermont Diabetes Information System on Inpatient and Emergency Department Use: Results from a Randomized Trial

  • Shamima Khan, MBA, PhD

      Affiliations

    • Department of Pharmacy Administration and Allied Health Sciences, College of Pharmacy and Allied Health Professions, St. John’s University, Jamaica, New York
    • Corresponding Author InformationCorresponding Author: Shamima Khan, MBA, PhD, Department of Pharmacy Administration and Allied Health Sciences, College of Pharmacy and Allied Health Professions, St. Albert’s Hall, Room 108, St. John’s University, Jamaica, NY.
    • ,
  • Charles D. MacLean, MDCM

      Affiliations

    • Division of General Internal Medicine, University of Vermont, Burlington, Vermont
    • ,
  • Benjamin Littenberg, MD

      Affiliations

    • Division of General Internal Medicine, University of Vermont, Burlington, Vermont

published online 17 May 2010.

Abstract 

Objective

To describe the effect of the Vermont Diabetes Information System (VDIS) on hospital and emergency department use.

Data Source

Statewide discharge database.

Study Design

Randomized controlled trial of a decision support system for 7412 adults with diabetes and their 64 primary care providers.

Data Collection/Data Extraction

Charges and dates for hospital admissions and emergency department care in Vermont during an average of 32 months of observation. Data from New York hospitals were not available.

Results

Patients randomized to VDIS were admitted to the hospital less often than control subjects (0.17 admissions vs 0.20; P=.01) and generated lower hospital charges ($3113 vs $3480; P=.019). VDIS patients also had lower emergency department utilization (0.27 visits vs 0.36; P <.0001) and charges ($304 vs $414; P <.0001). The intervention was particularly effective in men and in older subjects.

Conclusions

Despite data limitations that tended to reduce the apparent effect of the system, this randomized, controlled trial showed that VDIS reduces hospitalization and emergency department utilization and expenses.

Keywords: Chronic disease, Clinical, Cost of care, Decision support systems, Diabetes mellitus, Emergency department use, Health services research, Hospitalization, Patient care management, Primary health care

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 Funded by the National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK61167 and K24 DK068380).

 Conflict of interest: Drs. MacLean and Littenberg, along with the University of Vermont, hold equity in Vermedx, Inc., which distributes the Vermedx® Diabetes Information System, which is based on the work described in this manuscript. The authors comply with all conflict of interest policies of the National Institutes of Health and of the University of Vermont.

PII: S1877-1319(10)00006-6

doi:10.1016/j.ehrm.2010.03.002

Health Outcomes Research in Medicine
Volume 1, Issue 1 , Pages e61-e66, July 2010

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