The Effect of the Vermont Diabetes Information System on Inpatient and Emergency Department Use: Results from a Randomized Trial

Objective

To describe the effect of the Vermont Diabetes Information System (VDIS) on hospital and emergency department use.

Data Source

Statewide discharge database.

Study Design

Randomized controlled trial of a decision support system for 7412 adults with diabetes and their 64 primary care providers.

Data Collection/Data Extraction

Charges and dates for hospital admissions and emergency department care in Vermont during an average of 32 months of observation. Data from New York hospitals were not available.

Results

Patients randomized to VDIS were admitted to the hospital less often than control subjects (0.17 admissions vs 0.20; P = .01) and generated lower hospital charges ($3113 vs $3480; P = .019). VDIS patients also had lower emergency department utilization (0.27 visits vs 0.36; P <.0001) and charges ($304 vs $414; P <.0001). The intervention was particularly effective in men and in older subjects.

Conclusions

Despite data limitations that tended to reduce the apparent effect of the system, this randomized, controlled trial showed that VDIS reduces hospitalization and emergency department utilization and expenses.