Inpatient to outpatient transfer of diabetes care: Perceptions of barriers to postdischarge followup in urban African American patients

Abstract

Objectives: To determine potential obstacles to postdischarge followup of hospitalized diabetes patients and to inform planning to better ensure continuity of service when care is transferred from inpatient to outpatient settings. Design: Surveys of hospital inpatients Setting: Urban hospital Patients: Inpatients with diabetes mellitus Main Outcome Measures: Identification of barriers to postdischarge followup in relation to age, sex, race, marital status, employment status, educational level, health insurance status, date of admission, date of diagnosis, admission and discharge glucose values, and hyperglycemia medications at discharge. Results: Of 303 respondents (average age 50 years, 46% women, 91 % African American), 95% indicated that they planned to use follow-up services. Fifty percent of these patients anticipated encountering barriers to keeping outpatient appointments. The primary reasons were transportation problems (59%), inability to afford the visit (34%), and lack of health insurance (24%). Among persons expecting difficulty with follow-up care, significantly more were uninsured (P=.025), and a greater proportion had prior trouble accessing medical care (P