Journal of Education and Health Promotion

Abstract BACKGROUND: More than one‑half of people with diabetes need at least one surgery in their
lifespan. Few studies have addressed how to manage the needs of these patients after discharge
from the hospital. The present study is designed to determine the effect of home care on readmission
of Type 2 diabetic patients who underwent surgical procedures.
MATERIALS AND METHODS: The present study was a randomized clinical trial. Sixty‑nine
patients with Type 2 diabetes undergoing surgery were assigned to the intervention and control
groups via blocking order in the selected educational hospitals of Isfahan 2019. Home care
was performed for 3 months with interprofessional team approach. Data collection tools were
re‑admission checklist. Data were entered in SPSS software version 23 and were analyzed by
nonparametric tests.
RESULTS: The background characteristics in the intervention and control groups were not different.
The frequency of readmission in the control and intervention groups from the time of discharge until
3 months later was 25.7% and 18.9%, respectively. Frequency of readmission in the intervention
and control groups was not significant in 3 months from discharge, P > 0.05. The mortality rate was
11.4% and 0% in control and intervention groups, respectively, P < 0.05.
CONCLUSION: It can be argued that continued home care can decrease the rate of readmission
and mortality rate in patients with Type 2 diabetes who will discharge from surgical wards.

Abstract Background: The rate of hospital deductions is a commonly cited concern among teaching
hospitals in Iran. The objective of the present study is to access the effect of the quantitative
and qualitative analysis of inpatient medical records on deductions and identifying the major
resources of deductions. There are currently no published interventional studies that have
investigated this issue quantitatively. Materials and Methods: In an interventional study,
we reviewed all the 192 patient’s medical records (PMRs) for any documentation errors, to
determine the rate of deductions. We conducted a pilot of 30 cases prior to the actual survey.
Nonprobability‑based consecutive sampling was used. The main study was conducted in three
phases: 1. Primary evaluation; 2. Training, performance of intervention and corrective actions;
and 3. Final assessment. Comprehensive assessments of medical records and follow‑up of
error correction were carried out systematically and according to the pre‑set schedule. Pre‑ and
post‑intervention assessments were compared in order to evaluate the effect of the intervention.
Data were analyzed using the SPSS‑20 statistical software. Paired‑sample t‑test was used to
compare changes in deduction scores before and after the intervention. Differences at a P value
less than 0.05 were considered statistically significant. Results: In the initial survey of 800 PMRs,
nearly one quarter (24%) (Or 192 cases) had at least one type of deduction. The three top types
of deductions were Laboratory (47.9%), Medical radiation (45.3%), and Physician visit (35.9%).
The results showed a 2.7‑ to about 36‑fold lower rate of hospital deductions (average: 6.4‑fold;
reduction from 21131 to 3285 US dollars). Conclusion: All in all, the results of the present study
indicated that educational interventions and quantitative and qualitative analysis of inpatient
medical records are very beneficial and effective in the reduction of medical record deductions.