{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:36:25Z","timestamp":1789749385288,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T00:00:00Z","timestamp":1564704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine whether the Diabetes Inpatient Care and Education (<jats:styled-content style=\"fixed-case\">DICE<\/jats:styled-content>) programme, a whole\u2010systems approach to managing inpatient diabetes, reduces length of stay, in\u2010hospital mortality and readmissions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Research design and methods<\/jats:title><jats:p>Diabetes Inpatient Care and Education initiatives included identification of all diabetes admissions, a novel <jats:styled-content style=\"fixed-case\">DICE<\/jats:styled-content> care\u2010pathway, an online system for prioritizing referrals, use of web\u2010linked glucose meters, an enhanced diabetes team, and novel diabetes training for doctors. Patient administration system data were extracted for people admitted to Ipswich Hospital from January 2008 to June 2016. Logistic regression was used to compare binary outcomes (mortality, 30\u2010day readmissions) 6 months before and after the intervention; generalized estimating equations were used to compare lengths of stay. Interrupted time series analysis was performed over the full 7.5\u2010year period to account for secular trends.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Before\u2010and\u2010after analysis revealed a significant reduction in lengths of stay for people with and without diabetes: relative ratios 0.89 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.83, 0.97) and 0.93 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.90, 0.96), respectively; however, in interrupted time series analysis the change in long\u2010term trend for length of stay following the intervention was significant only for people with diabetes (<jats:italic>P<\/jats:italic>=0.017 vs <jats:italic>P<\/jats:italic>=0.48). Odds ratios for mortality were 0.63 (0.48, 0.82) and 0.81 (0.70, 0.93) in people with and without diabetes, respectively; however, the change in trend was not significant in people with diabetes, while there was an apparent increase in those without diabetes. There was no significant change in 30\u2010day readmissions, but interrupted time series analysis showed a rising trend in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">DICE<\/jats:styled-content> programme was associated with a shorter length of stay in inpatients with diabetes beyond that observed in people without diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14062","type":"journal-article","created":{"date-parts":[[2019,7,2]],"date-time":"2019-07-02T14:21:53Z","timestamp":1562077313000},"page":"277-285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Impact of the Diabetes Inpatient Care and Education (<scp>DICE<\/scp>) project on length of stay and mortality"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7632-5587","authenticated-orcid":false,"given":"F.","family":"Akiboye","sequence":"first","affiliation":[{"name":"Diabetes Research Unit Ipswich Hospital NHS Trust Ipswich UK"},{"name":"Institute of Applied Health Research University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0543-3254","authenticated-orcid":false,"given":"N. J.","family":"Adderley","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Martin","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Gokhale","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. M.","family":"Rudge","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. P.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Rajendran","sequence":"additional","affiliation":[{"name":"Diabetes Research Unit Ipswich Hospital NHS Trust Ipswich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Nirantharakumar","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3331-7015","authenticated-orcid":false,"given":"G.","family":"Rayman","sequence":"additional","affiliation":[{"name":"Diabetes Research Unit Ipswich Hospital NHS Trust Ipswich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the DICE team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,2]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Diabetes expenditure, burden of disease and management 5 EU countries","author":"Kanvos P","year":"2012"},{"key":"e_1_2_9_3_1","unstructured":"NHS Digital.National diabetes inpatient Audit 2011. Available athttps:\/\/digital.nhs.uk\/catalougue\/PUB06279. Last accessed 6 February 2017."},{"key":"e_1_2_9_4_1","unstructured":"NHS Digital.National Diabetes Inpatient Audit (NADiA) 2017. Available athttps:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/national-diabetes-inpatient-audit\/national-diabetes-inpatient-audit-nadia-2017. Last accessed 13 September 2018."},{"key":"e_1_2_9_5_1","volume-title":"Diabetes tied to a third of California hospital stays, driving health care costs higher","author":"Meng YY","year":"2014"},{"key":"e_1_2_9_6_1","unstructured":"KerrM.Inpatient Care for People with Diabetes: The Economic Case for Change. : NHS diabetes November 2011. Available athttps:\/\/www.diabetes.org.uk\/resources-s3\/2017-10\/Inpatient%20Care%20for%20People%20with%20Diabetes%20%20The%20Economic%20Nov%202011_1.pdf. 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