Home Ward Care Outcomes and Determinants in Poorly Controlled Type 2 Diabetes Patients from Primary Care Cluster Buddhasothorn Hospital

Abstract

Background: Currently, Buddhasothorn Hospital implemented the Home Ward model for patients with hyperglycemia to reduce hospital overcrowding and improve the quality of life for both patients and caregivers. However, evidence regarding the outcomes of this service remains limited. Therefore, this study aimed to investigate the outcomes of the Home Ward service among patients with uncontrolled diabetes at primary care units.

Objective: To evaluate the outcomes of the Home Ward service on glycemic levels and to identify factors associated with glycemic control among patients with uncontrolled type 2 diabetes at the primary care units of Buddhasothorn Hospital.

Methods: This retrospective descriptive-analytic study evaluated 73 patients with type 2 diabetes. Data were retrieved from the A-MED and HosXP systems between October 1, 2024, and September 30, 2025. Data analysis was performed using descriptive statistics, paired t-test, and logistic regression.

Results: Following the intervention, patients demonstrated reductions in both hemoglobin A1c (HbA1c) and fasting blood sugar (FBS) levels at 3 and 6 months. The reduction in HbA1c was statistically significant (p < 0.001). Multiple logistic regression analysis revealed that factors significantly associated with uncontrolled blood glucose levels included obesity with a BMI ≥ 25 kg/m² (aOR = 3.14, 95% CI: 1.29 - 7.62, p = 0.011), a baseline HbA1c >12 (aOR = 2.68, 95% CI: 1.19 - 6.01, p = 0.017), and a duration of care under the Home Ward program of less than 7 days (aOR = 2.68, 95% CI: 1.19 - 6.01, p = 0.017)

Conclusion: The Home Ward care model was significantly associated with a reduction in glycemic levels. Furthermore, a body mass index BMI ≥ 25 kg/m², a baseline HbA1c >12, and a duration of admission less than 7 days were key factors significantly associated with glycemic control in this patient population.