PMID- 28660256
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2509-4262 (Print)
IS  - 2509-4254 (Electronic)
IS  - 2509-4262 (Linking)
VI  - 1
IP  - 2
DP  - 2017
TI  - A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 
      Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens.
PG  - 109-115
LID - 10.1007/s41669-017-0020-9 [doi]
AB  - BACKGROUND: The identification of cost-effective glycaemic management strategies 
      is critical to hospitals. Treatment with a basal-bolus insulin (BBI) regimen has 
      been shown to result in better glycaemic control and fewer complications than 
      sliding scale regular insulin (SSI) in general surgery patients with type 2 
      diabetes mellitus (T2DM), but the effect on costs is unknown. OBJECTIVE: We 
      conducted a post hoc analysis of the RABBIT Surgery trial to examine whether 
      total inpatient costs per day for general surgery patients with T2DM treated with 
      BBI (n = 103) differed from those for patients with T2DM treated with SSI 
      (n = 99) regimens. METHODS: Data were collected from patient clinical and 
      hospital billing records. Charges were adjusted to reflect hospital costs. 
      General linearized models were used to estimate the risk-adjusted effects of BBI 
      versus SSI treatment on average total inpatient costs per day. RESULTS: 
      Risk-adjusted average total inpatient costs per day were $US5404. Treatment with 
      BBI compared with SSI reduced average total inpatient costs per day by $US751 
      (14%; 95% confidence interval [CI] 20-4). Being treated in a university medical 
      centre, being African American or having a bowel procedure or higher-volume 
      pharmacy use significantly reduced costs per day. CONCLUSIONS: In general surgery 
      patients with T2DM, a BBI regimen significantly reduced average total hospital 
      costs per day compared with an SSI regimen. BBI has been shown to improve 
      outcomes in a randomized controlled trial. Those results, combined with our 
      findings regarding savings, suggest that hospitals should consider adopting BBI 
      regimens in patients with T2DM undergoing surgery.
FAU - Phillips, Victoria L
AU  - Phillips VL
AD  - Department of Health Policy and Management, Rollins School of Public Health of 
      Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA. ISNI: 0000 0001 0941 
      6502. GRID: grid.189967.8
FAU - Byrd, Anwar L
AU  - Byrd AL
AD  - Department of Medicine, Division of Endocrinology, Emory University School of 
      Medicine, Atlanta, GA USA. ISNI: 0000 0001 0941 6502. GRID: grid.189967.8
FAU - Adeel, Saira
AU  - Adeel S
AD  - Department of Medicine, Division of Endocrinology, Emory University School of 
      Medicine, Atlanta, GA USA. ISNI: 0000 0001 0941 6502. GRID: grid.189967.8
FAU - Peng, Limin
AU  - Peng L
AD  - Department of Biostatistics, Rollins School of Public Health, Atlanta, GA USA. 
      ISNI: 0000 0001 0941 6502. GRID: grid.189967.8
FAU - Smiley, Dawn D
AU  - Smiley DD
AD  - Department of Medicine, Division of Endocrinology, Emory University School of 
      Medicine, Atlanta, GA USA. ISNI: 0000 0001 0941 6502. GRID: grid.189967.8
FAU - Umpierrez, Guillermo E
AU  - Umpierrez GE
AD  - Department of Medicine, Division of Endocrinology, Emory University School of 
      Medicine, Atlanta, GA USA. ISNI: 0000 0001 0941 6502. GRID: grid.189967.8
LA  - eng
GR  - M01 RR000039/RR/NCRR NIH HHS/United States
GR  - UL1 RR025008/RR/NCRR NIH HHS/United States
GR  - UL1 TR000454/TR/NCATS NIH HHS/United States
PT  - Journal Article
DEP - 20170421
PL  - Switzerland
TA  - Pharmacoecon Open
JT  - PharmacoEconomics - open
JID - 101700780
PMC - PMC5468101
COIS- This study is adjunct to the RABBIT 2 Surgery trial (ClinicalTrials.gov 
      identification: NCT00596687) [10]. Pilot data from this study were presented in 
      abstract form at the 73rd Scientific Sessions of the American Diabetes 
      Association, Chicago, IL. The Emory University Institutional Review Board (IRB) 
      approved this study and informed consent was obtained for all patients in 
      accordance with IRB guidelines. CONFLICT OF INTEREST: Victoria L Phillips, Anwar 
      L Byrd, Saira Adeel, Limin Peng, Dawn D Smiley and Guillermo E Umpierrez, have no 
      conflicts of interest, financial or otherwise, in relation to the manuscript. 
      FUNDING: This investigator-initiated study was supported by an unrestricted grant 
      from Sanofi (Bridgewater, NJ, USA). The sponsor had no input into the results 
      presented here. DATA AVAILABILITY STATEMENT: The dataset contains complete 
      medical records for the sample. Upon request, the authors will provide a 
      de-identified dataset. Given the nature of the data, the Institutional Review 
      Board require the authors to catalogue researchers accessing the data.
EDAT- 2017/07/01 06:00
MHDA- 2017/07/01 06:01
PMCR- 2017/04/21
CRDT- 2017/06/30 06:00
PHST- 2017/06/30 06:00 [entrez]
PHST- 2017/07/01 06:00 [pubmed]
PHST- 2017/07/01 06:01 [medline]
PHST- 2017/04/21 00:00 [pmc-release]
AID - 20 [pii]
AID - 10.1007/s41669-017-0020-9 [doi]
PST - ppublish
SO  - Pharmacoecon Open. 2017;1(2):109-115. doi: 10.1007/s41669-017-0020-9. Epub 2017 
      Apr 21.