Measures
The primary outcome measure of effectiveness was A1c.
Disease severity was measured using the Diabetes Severity
Index (Young et al., 2008). This index is a useful tool
for prediction of mortality and hospitalization risk. Each
level of the continuous score is associated with a 1.34-fold
(95% CI = 1.28, 1.41) greater risk of death and risk of hospitalization.
Therefore, our mean Diabetes Severity Index
score of 3.01 indicated a 4.03-fold risk of hospitalization
and mortality. We also obtained mean A1c for all patients
with diabetes at the Cleveland VA Medical Center-Wade
Park Division for fiscal years (FY) 2005–2012. Data were
extracted from the hospitals’ electronic record and the
registry.