Factors Influencing Hospital Conveyance Following Ambulance Attendance for People with Diabetes: A Retrospective Observational Study

Hugo van Woerden, Magda Bucholc, Benjamin Clubbs Coldron, Vivien Coates, Janet Heaton, Michael McCann, Nikki Perrin, Ryan Waterson, Aoife Watson, Sandra MacRury

Research output: Contribution to journalArticle

Abstract

Aims: To assess variables contributing to hospital conveyance for people with diabetes and the interactions between them. A secondary aim was to generate hypotheses for further research into interventions that might reduce avoidable hospital admissions.
Methods: A national retrospective dataset including 30,999 diabetes related call-outs from the Scottish Ambulance Service was utilised covering a 5-year period between 2013-17. The relationship between diabetes related hospital conveyance and 7 potential risk factors was analysed. Independent variables included: age, gender, deprivation, paramedic attendance, treatment at the scene, first blood glucose measurement and day of the week.
Results: In Scotland, hyperglycaemia was associated with a higher number of people being conveyed to hospital than hypoglycaemia (49.8% of those conveyed had high blood sugar vs 39.3% with low sugar, p≤0.0001). Treatment provided in pre-hospital care was associated with reduced conveyance rates (47.3% where treatment was administered vs 58.2% p≤ 0.0001). Paramedic attendance was also associated with reduced conveyance to hospital (51.4% where paramedic was present vs 59.5% p≤ 0.0001). Paramedic attendance in hyperglycaemic cases was associated with significantly reduced odds of conveyance (OR 0.52; p≤0.001).
Conclusions: A higher rate of conveyance associated with hyperglycaemic cases indicates a need for more resources, education and training in this area. Higher conveyance rates were also associated with no paramedic being present and no treatment being administered. This suggests that paramedic attendance may be crucial in reducing avoidable admissions. Developing and validating protocols for pre-hospital services and treatment, may help to reduce hospital conveyance rates.
Original languageEnglish
Article numbere14384
JournalDiabetic medicine
Early online date15 Aug 2020
DOIs
Publication statusE-pub ahead of print - 15 Aug 2020

Keywords

  • diabetes
  • Healthcare Delivery
  • environmental factors
  • Hyperglycaemia
  • Hypoglycaemia
  • Self-management
  • Sociological aspects
  • ambulance service
  • hospital admission

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