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Introduction - Analysis of Diabetes Mellitus as a Secondary Diagnosis After Surgery and Its Impact on Cost and Care Intensity at Bottlebrush Hospital
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Generation of the issue of diabetes mellitus (DM) as the secondary health issue after surgery that can extend the stay in hospital is a serious issue now. This study will provide details of the analysis of the data aligning with the objectives and research questions after with recommendations will be provided to reduce issues for Bottlebrush Hospital
Component 1: Result
The analysis of the provided dataset indicates the issue of DM as the secondary diagnosis for patients who have experienced surgery in the Bottlebrush Hospital. DRG description is selected as the dependent variable based on which different aspects are analysed here for understanding the issue of DM as the secondary diagnosis that has increased the cost of hospital functions for Bottlebrush Hospital.
Figure 1: DRG vs. LOS
This is a graphical representation between DRG vs. LOS after analysis of the data of Bottlebrush Hospital. Data indicates caesarean delivery has the maximum contribution in generation of after surgery secondary DM issues. Therefore, this issue causes extension of the stay of patients in hospitals for which engagement of equipment has increased the cost of patient largely. Other surgeries are also mentioned that have contributed to the DM issue that increase the cost of patient that has supported the research question along with the objective of this research.
Figure 2: DRG vs. Age
The above graphical representation indicates that age is another factor that sometimes causes DM issues along with a long stay in hospital that increases the cost. The graphical representation indicates age ranges from 24 to 28 years have the maximum issue of after surgery DM that increases the cost of Bottlebrush Hospital. Therefore, this outcome supports the question that patients need greater intensity of care after surgery. Objectives are also aligned effectively with this analysis to identify that different aged patients have the DM issue after surgery that increases cost of patients in hospital.
Figure 3: DRG vs. discharge intention
The above graphics analysis indicates that caesarean surgery is the important one that contributes the most to late discharge due to generation of DM issues. However, abdominal pain, adrenaline issues, and childhood mental issues are the other issues that cause DM generation along with surgery. These secondary DM issues cause longer stay in hospital for patients for which their cost increases along with the use of the equipment of the hospital that reduces the availability of services to other patients that have a serious illness. Therefore, the outcome has supported the research question and objectives regarding cost increasing and lesser intensity of care for patients.
Figure 4: DRG vs. ICU hours
The above graphical representation indicates a disorder of minor skin causes maximum ICU hours that enhance the cost of patients due to an increase in the greater intensity of the health care. Therefore, it is clear that DM generation and treatment after surgery as a secondary diagnosis of most patients is the issue of Bottlebrush Hospital that meets the research question along with objectives that are presented here.
Figure 5: DRG vs. Mech Vent Hours
This graph supports the research question and objectives as it helps in identification of the use of mechanical vents as life support that increases cost of patients. Minor skin disease is one of the causes that include the use of mechanical vents for patients.
Component 2: Discussion
Surgery causes generation of DM issue among patients
Objectives indicate that critical surgery has a strong influence on a generation of after surgery issues of DM for which secondary diagnosis is required. Serious surgery causes improper balance of the hormones that generate DM issues especially after surgery for which longer stay in hospital increases cost. An example is a bariatric surgery is a serious surgery that causes the generation of critical DM issues after this surgery (Aminian et al. 2020). Surgery causes improper functioning of insulin that causes sudden generation of DM issue after any serious surgery of a patient of different age. In contrast, Radhakrishnan and Haridas (2020) have opined that surgical operation has a great influence on duodenal and jejunal functionalities that influence the glucose homeostasis to reduce insulin functionality that generates DM issues after surgery. Therefore, it can be understood after the analysis that surgery is an essential initiator of DM issue that causes secondary diagnosis of patients with an increase of care intensity, cost, and admission to hospital for a longer time.
Figure 6: Serious surgery that cause DM issue
(Source: Aminian et al. 2020, Radhakrishnan and Haridas, 2020)
Further, an increase of the DM issue causes a reduction in healing of wounds after surgery for which a patient needs a secondary diagnosis in Bottlebrush Hospital. DM issues are sometimes severe that causes side effects for patients especially after surgery for which proper treatment is required for long-term risk mitigation (O'Brien et al. 2018). Therefore, surgery needs to be done with proper testing along with a strategy of reduction of DM issues in this hospital. Therefore, the outcome from the dataset analysis and the literature is almost identical to identify surgery as a contributor to DM issues.
Secondary diagnosis of DM after surgery increases influence on discharge intention
The intention of discharge after surgery is based on the after surgery influence on the patient, which is a DM issue mentioned in the research question as well as in objectives. Issue of DM after any serious surgery causes risk of serious health issues that influence the discharge intention of patients. Patients with the risk factors of DM even after the surgery elevate the risk of cardiovascular disease sometimes that can influence the discharge intention strongly (Tanaka et al. 2020). Therefore, for such serious health issues, an influential secondary diagnosis is required especially for ageing people to reduce the risk of DM. In contrast, Ng et al. (2019) have said that DM is a common endocrinology disease that causes a serious failure of the heart for patients even after surgery. Therefore, it is understood that discharge intention is completely based on the generation of DM after surgery. Primary analysis indicates caesarean issue and abdominal pain are the causes for which discharge intension can change. Issues such as those after surgery can increase the intensity of healthcare facility as well as cost along with longer stay in Bottlebrush Hospital. Therefore, this analytical outcome strongly supports the primary analysis result along with the objectives that indicate an influence of DM as a secondary diagnosis in discharge intention from the hospital.
Figure 7: Issue of DM in health
(Source: Tanaka et al. 2020, Ng et al. 2019)
Age-related DM issue of patients causes longer stay in hospital
Age is an important factor in generation of DM however, based on the analysis of data, it is observed that surgery influences the issue of DM generation whatever the age of the patient is. The objective indicates that different group of patients having different ages have experienced the issue of DM after surgery in Bottlebrush Hospital. According to Schmidt (2019), evidence from the research indicates that DM issues can be accompanied by the pro-inflammatory state that can influence the bio-mark inflammatory responses. DM issue in general increases with increase the age of people however; surgery creates a misbalance of hormonal tasks that cause DM issues as a secondary diagnosis even at an early age. In contrast, Chattu et al. (2019) have opined that insufficient sleeping issues or even other health hazards can generate DM problems at an early age for children or even people having lesser age. Therefore, it can easily be analysed from the fact that the DM issue does not depend on age only as mentioned in the primary analyses as 24 to 28 years of age causes DM issue. Surgery has a negative influence on health functions that causes DM issues for which after surgery secondary diagnosis is required with increased cost and influential care for patients. However, recent data indicates that the DM risk factors are reducing every year to improve secondary diagnosis along with intensive care for patients (Pubmed.ncbi.nlm.nih.gov, 2020). Therefore, the primary analysis outcome is well supportive with the outcome from literature that strongly supports DM can increase longer stay in hospital for patients after surgery.
Figure 8: Causes of DM issue and secondary DM treatment after surgery
(Source: Schmidt, 2019, Chattu et al. 2019)
ICU hours and mechanical vent use increase the cost and intensity of care
ICU hours and the use of mechanical vent for intensive care of patients are costly enough that sometimes creates a burden for patients. The objective indicates an increase in the cost due to long-term hospitalisation of patients for secondary DM treatment after surgery. The analysis of the data indicates that minor skin disease is an issue after surgery that sometimes causes larger stay in hospital along with use of mechanical vent and ICU for patients. ICU use and the use of mechanical vents can be termed as two most costly intensive care strategies for patients that increase the cost structure during any treatment (Kaier et al. 2020). ICU causes serious intensive care by healthcare professionals along with the use of modern healthcare machines that increase the cost for patients. In contrast, Vasilevskis et al. (2018) have said that since ICU includes advanced machinery, survival after surgery can face increased costs. Therefore, it is clear that the analysis data is supported by the literature outcome here to super the cost increase for patients due to ICU facilities along with intensive care in mechanical vent. Primary analyses support that skin disorders s after surgery sometimes causes ICU admission. Therefore, the outcome of dataset analysis and objectives are well aligned with the literature analysis for supporting cost increase influence due to ICU and mechanical vent facility for patients who stay in hospital for a longer-term.
Component 3: Recommendations
Initial testing of patient before surgery
Initial testing of the patient before any serious surgery can be beneficial for the Bottlebrush Hospital to reduce the risk of DM and a secondary diagnosis of DM. This testing helps in improvement of satisfaction of patients along with maintenance of accuracy of the respective health issue. DM is generally an issue of improper generation of insulin that causes chronic disorder of metabolism (Rivera-Mancía et al. 2018). Therefore, initial testing can be beneficial to detect the issue of DM condition of a patient before surgery using which accuracy in surgery and treatment can be provided.
Different treatment strategies of DM for different age
Age is an important part of which different DM treatments can be possible to patients after surgery. DM is recently a major health problem of the public for which different treatments can reduce the risk factors for different age patients after surgery (Agache et al. 2018). Therefore, planning for that different treatment for different age groups can be vital that can sometimes reduce the cost of treatment along with reduction of bed occupancy in the Bottlebrush Hospital. Further, after surgery, a thorough check-up for the elderly can be helpful to determine the rate of DM issues that can help in maintaining accuracy in DM treatment. Bottlebrush Hospital can separate their unit more accurately to maintain surgery of different age groups along with secondary DM treatment.
Reduction of cost of ICU and mechanical vent with planning
Bottlebrush Hospital can reduce its ICU and mechanical vent cost of its patients who suffer from after surgery DM or other issues. This strategy will be beneficial in improving service along with the satisfaction of patients during treatment. Satisfaction of patients indicates the success of healthcare service at an affordable cost for which the patient can avail the service in future (Manzoor et al. 2019). Therefore, Bottlebrush Hospital can separate the section of ICU for those patients who have DRM tissue after surgery from others to maintain the ICU available for other serious patient services. This will increase the capacity of ICU along with effective handling of patients with better intensive care.
Trained staff inclusion for timely discharge
Trained healthcare staff inclusion for surgery and DM treatment can help Bottlebrush Hospital to reduce discharge time after surgery or even secondary diagnosis of DM. Assistants of healthcare provide essential care for different vulnerable patients using their skills (Handley et al. 2019). Therefore, Bottlebrush Hospital can recruit skilled staff for patient care especially for surgery to reduce the risk of DM issues after surgery. Further, staff who can provide effective treatment to patients who are admitted to secondary DM treatment in hospitals can reduce the cost with intensive care through which long-term hospitalisation can be eliminated.
Conclusion
This study has analysed the analysis of the dataset to identify the issue of secondary DM treatment after surgery in Bottlebrush Hospital. Literature are analysed here for support of the primary analysis of the dataset that indicates the result is accurate enough. Recommendations include trained staff selection, separate treatment for DM, cost reduction for ICU and effective initial testing before surgery.
Reference list
Journals
Agache, A., Must??ea, P., Mihalache, O., Bobîrca, F.T., Georgescu, D.E., Jauca, C.M., Bîrligea, A., Doran, H. and P?tra?cu, T., 2018. Diabetes mellitus as a risk-factor for colorectal cancer literature review-current situation and future perspectives. Chirurgia (Bucur), 113(5), pp.603-610.
Aminian, A., Vidal, J., Salminen, P., Still, C.D., Hanipah, Z.N., Sharma, G., Tu, C., Wood, G.C., Ibarzabal, A., Jimenez, A. and Brethauer, S.A., 2020. Late relapse of diabetes after bariatric surgery: not rare, but not a failure. Diabetes Care, 43(3), pp.534-540.
Chattu, V.K., Chattu, S.K., Burman, D., Spence, D.W. and Pandi-Perumal, S.R., 2019, March. The interlinked rising epidemic of insufficient sleep and diabetes mellitus. In Healthcare (Vol. 7, No. 1, p. 37). Multidisciplinary Digital Publishing Institute.
Handley, M., Bunn, F. and Goodman, C., 2019. Supporting general hospital staff to provide dementia sensitive care: A realist evaluation. International journal of nursing studies, 96, pp.61-71.
Kaier, K., Heister, T., Wolff, J. and Wolkewitz, M., 2020. Mechanical ventilation and the daily cost of ICU care. BMC health services research, 20(1), pp.1-5.
Manzoor, F., Wei, L., Hussain, A., Asif, M. and Shah, S.I.A., 2019. Patient satisfaction with health care services; an application of physician’s behavior as a moderator. International journal of environmental research and public health, 16(18), p.3318.
Ng, A.C., Bertini, M., Ewe, S.H., van der Velde, E.T., Leung, D.Y., Delgado, V. and Bax, J.J., 2019. Defining subclinical myocardial dysfunction and implications for patients with diabetes mellitus and preserved ejection fraction. The American journal of cardiology, 124(6), pp.892-898.
O'Brien, R., Johnson, E., Haneuse, S., Coleman, K.J., O'Connor, P.J., Fisher, D.P., Sidney, S., Bogart, A., Theis, M.K., Anau, J. and Schroeder, E.B., 2018. Microvascular outcomes in patients with diabetes after bariatric surgery versus usual care: a matched cohort study. Annals of internal medicine, 169(5), pp.300-310.
Radhakrishnan, L. and Haridas, T.V., 2020. The effect on glycemic status in type 2 diabetes mellitus after gastric cancer surgery. International Surgery Journal, 8(1), pp.191-195.
Rivera-Mancía, S., Trujillo, J. and Chaverri, J.P., 2018. Utility of curcumin for the treatment of diabetes mellitus: evidence from preclinical and clinical studies. Journal of Nutrition & Intermediary Metabolism, 14, pp.29-41.
Schmidt, A.M., 2019. Diabetes mellitus and cardiovascular disease: emerging therapeutic approaches. Arteriosclerosis, thrombosis, and vascular biology, 39(4), pp.558-568.
Tanaka, M., Okada, H., Hashimoto, Y., Kumagai, M., Nishimura, H. and Fukui, M., 2020. Low-attenuation muscle is a predictor of diabetes mellitus: a population-based cohort study. Nutrition, 74, p.110752.
Vasilevskis, E.E., Chandrasekhar, R., Holtze, C.H., Graves, J., Speroff, T., Girard, T.D., Patel, M.B., Hughes, C.G., Cao, A., Pandharipande, P.P. and Ely, E.W., 2018. The cost of ICU delirium and coma in the intensive care unit patient. Medical care, 56(10), p.890.
Website
Pubmed.ncbi.nlm.nih.gov, 2020. Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses, Available at: https://pubmed.ncbi.nlm.nih.gov/33313987/#:~:text=Each%201%20year%20increase%20in,(all%20p%20%3C%200.001) Accessed on: 21/01/2022]
