Factors Leading to DKA Readmissions: A Qualitative Study

Abstract

Diabetic patients readmitted with diabetic ketoacidosis account for more than 130,000 hospital readmissions per year at an annualized cost of $2.4 billion (Langley et al., 2015). The purpose of this study was to understand the social determinants of health (SDoH) that may lead to hospital readmissions for diabetic ketoacidosis (DKA). Social Determinants of Health included “socioeconomic factors, psychosocial factors, neighborhood environment, and political/ economic/ cultural drivers (Walker, Williams, & Egede, 2016, p.368).” Social determinants of health are major contributors to diabetes patients’ health. Social support and socioeconomic status play a major role in the health of diabetics that readmit frequently for diabetic ketoacidosis. Further, they have direct impacts on glycemic control and the compliance rates of diabetic medications that can lead to higher readmission rates if not taken as prescribed. Understanding the SDoH that lead to readmissions informs the development of interventions that improve the health of patients with diabetes, reduces readmission rates, and decreases the cost burden for patients and healthcare organizations. From a parent study investigating factors that lead to patients with diabetes readmission in diabetic ketoacidosis, I conducted a secondary analysis through the new lens of the social determinants of health. A qualitative content analysis method was used to describe the SDoH that contribute to patients with diabetes readmission in DKA. Preliminary findings suggest that the social factors that contribute to DKA readmissions are social support, spirituality, and psychosocial stressors. Implications for practice may include education development and counseling sessions to assist patients with identifying support systems to mitigate these social contributors to their readmissions. Furthermore, healthcare professionals can assist patients with identifying support systems that will facilitate alterations in health maintenance behaviors that may also prevent repeated readmissions.