The efficacy of hospital‐based interventions in reducing hospital length of stay for the inpatient with diabetes: A systematic review

Aim
Diabetes has a large and independent effect on hospital admissions, especially surgical admissions and the overall mean length of hospital stay (LOS) for inpatients with a diabetes diagnosis is almost twice that for patients without a diabetes diagnosis. This review aims to explore the efficacy of hospital-based interventions in reducing hospital length of stay for the inpatient living with diabetes.

Methods
A review of the literature was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Critical Appraisal Skills Programme used to assess the methodological quality of the included studies. The primary outcome was reduced hospital length of stay (LOS) with 17 studies meeting the inclusion criteria.

Results
Several categories of clinical intervention were identified that led to reduced LOS: Clinical procedures and treatment, education, multidisciplinary teams and diabetes inpatient specialist nurses and the use of technology. Specifically, use of clinical procedures and treatment reduced LOS by up to 38% with other studies demonstrating decreased LOS of up to 2.5 days. Education programmes presented positive results with mean LOS reduced 0.8 days and 1.95 days. Inpatient diabetes teams and specialist positions resulted in a decrease in LOS of up to 10.4 days across various studies while the use of technology significantly improved LOS by 1 day.

Conclusions
With diabetes resulting in extended LOS for the inpatient, hospital-based interventions that effectively reduce LOS are important and could enable faster hospital discharge. The clinical outcomes of this review highlight important implications in reducing hospital LOS.