SHM Converge Scientific Abstract ePoster Gallery-Failure of Follow-Up Amplifies Racial Disparities in Diabetic Ketoacidosis Readmissions

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This study examined racial and ethnic disparities in diabetic ketoacidosis (DKA) admissions, outpatient follow-up, and readmissions at Loma Linda University Children’s Hospital from January 2020 to July 2022. The investigators reviewed 640 Pediatric ICU DKA admissions and analyzed whether patients completed follow-up with Pediatric Endocrinology within 6 months of discharge, and whether they were readmitted for DKA within that time.<br /><br />The patient population was predominantly Hispanic (52%), followed by White (25%) and Black (18%) patients. Among patients who did complete follow-up, Black patients returned sooner after discharge than Hispanic and White patients, with an average of 46 days compared with 58 and 61 days, respectively.<br /><br />Overall, readmission within 6 months occurred in 13% of discharges when follow-up was completed, but it rose to 34% among patients who failed to follow up. This represented a 2.7-fold increase in readmission risk. The number needed to harm was 5 overall, meaning that for every five patients who missed follow-up, one additional DKA readmission occurred. The number needed to harm varied by race: 7 for Hispanic patients, 7 for White patients, and 3 for Black patients.<br /><br />The authors conclude that disparities exist both in DKA outcomes and in access to outpatient follow-up, with Black patients experiencing a higher burden of readmissions. To address this, the team plans a root cause analysis, patient surveys, and routine screening for social determinants of health that may interfere with follow-up care and contribute to preventable readmissions.

Asset Subtitle

Tiffany Seik-Ismail

Meta Tag

Author List Ekua Cobbina, Tiffany Seik-Ismail, Vallent Lee

Category Research

Concept Diabetic Ketoacidosis

Concept Outpatient Endocrinology Follow-Up

Concept Racial Disparity

Concept Ethnic Disparity

Concept Readmission

Distinguished Non-Finalist

Presenter Organization Loma Linda University Children's Hospital

Presenting Author Tiffany Seik-Ismail

Track Pediatric

Keywords

diabetic ketoacidosis

DKA admissions

racial disparities

ethnic disparities

pediatric endocrinology

outpatient follow-up

readmission risk

Pediatric ICU

Hispanic patients

Black patients

Diabetic Ketoacidosis

Outpatient Endocrinology Follow-Up

Racial Disparity

Ethnic Disparity

Readmission