Thirty-day readmission, length of stay and self-management behavior among patients with acute coronary syndrome and type 2 diabetes mellitus: a scoping review.

Abstract

AIMS AND OBJECTIVES\nTo summarize the current evidence on comorbid type 2 diabetes mellitus (T2DM) related to 30-day readmission and hospital length of stay (LOS) among patients with acute coronary syndrome (ACS) and evidence on the effectiveness of self-management programs for patients with both conditions.\n\n\nBACKGROUND\nACS and T2DM remain two major diseases leading to serious consequences. Thirty-day readmission and LOS were considered indicators of the quality of care, with the understanding that the potential significant effects of these outcomes could be varied.\n\n\nDESIGN\nThis scoping review followed the methodology described by Arksey and O Malley.\n\n\nMETHODS\nFive databases including PubMed, Embase, Cochrane Library, Web of Science and CINAHL were searched, and a total of 20 articles involving 913807 patients were included. Results were reported in accordance with PRISMA-ScR guidelines.\n\n\nRESULTS\nThe results indicated that patients with both ACS and T2DM have prolonged LOS and increased 30-day readmission rates. The findings supported that improvements in patient self-management behavior for optimal health outcomes was partially successful by effective self-management programs; however, few articles on intervention programs specifically designed for patients with two conditions were found.\n\n\nCONCLUSION\nProlonged LOS and increased 30-day readmission rates are found among patients with ACS and T2DM. Base on few pilot studies building on each other, the effectiveness of self-management programs in promoting self-care behavior, self-efficacy and knowledge for patients with ACS and T2DM cannot be concluded.\n\n\nRELEVANCE TO CLINICAL PRACTICE\nFindings from this review provide valuable information on and a better understanding of readmissions and LOS among patients with ACS and T2DM for healthcare providers. Future developments and implementations of effective self-management programs should target patients with dual diagnoses to improve health behavior and reduce readmission and LOS.