A chronic care model significantly decreases costs and healthcare utilisation in patients with inflammatory bowel disease

Sack, Coralynn; Phan, Véronique; Grafton, Rachel; Holtmann, Gerald; Langenberg, Daniel R. van; Brett, Kendra; Clark, Mike; Andrews, Jane M.

doi:10.1016/j.crohns.2011.08.019

Cited by 104 publications

(94 citation statements)

References 21 publications

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“…A formal IBDS was introduced in April 2008 11. This consisted of a dedicated weekly IBD clinic and a joint medical–surgical clinic for IBD patients.…”

Section: Methodsmentioning

confidence: 99%

A dedicated inflammatory bowel disease service quantitatively and qualitatively improves outcomes in less than 18 months: a prospective cohort study in a large metropolitan centre

Phan

Langenberg

Grafton

et al. 2012

Frontline Gastroenterol

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Introduction Maintaining high effi cacy and quality of care in infl ammatory bowel disease (IBD) management is a priority. The authors examined whether the introduction of a formal IBD Service (IBDS) positively infl uenced outcomes for their patients. Methods In 2007-2008, all IBD patients attending the Royal Adelaide Hospital were surveyed regarding clinical/demographic data, IBD knowledge, quality of life, mental health and satisfaction. Survey responders were re-surveyed ≥15 months later. Results 162 responded to survey 1 and 81 again responded to survey 2. Within the responders, 61% had Crohn's disease and 48% were men. Compared with survey 1, the proportions of patients with improved knowledge, adherence, satisfaction with care, QoL (≥5 points), anxiety and depression scores were 63% (95% CI 51 to 73), 62% (95% CI 50 to 72), 65% (95% CI 54 to 76), 42% (95% CI 31 to 54), 52% (95% CI 40 to 63) and 43% (95% CI 32 to 55), respectively. When comparing survey 2 with survey 1, reductions in hospitalisation (48% vs 30%, p=0.02), courses of corticosteroids and opiates (mean 1.63 vs 0.91 and 1.00 vs 0.61, both p<0.05) and overall medications (5.63 vs 4.65, p<0.05), were seen. Fewer 2009 non-responders required hospitalisation (53% vs 21%, p<0.001), suggesting a `cohort' rather than `responder-specifi c' effect. Conclusions The introduction of an IBDS resulted in improved patient outcomes with signifi cant reductions in negative markers for IBD morbidity including: hospitalisations, polypharmacy, steroid and opiate use. Despite increased costs in additional staff, these measures are likely to be cost effective.

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“…A formal IBDS was introduced in April 2008 11. This consisted of a dedicated weekly IBD clinic and a joint medical–surgical clinic for IBD patients.…”

Section: Methodsmentioning

confidence: 99%

A dedicated inflammatory bowel disease service quantitatively and qualitatively improves outcomes in less than 18 months: a prospective cohort study in a large metropolitan centre

Phan

Langenberg

Grafton

et al. 2012

Frontline Gastroenterol

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“…Sin duda, la implementación de estas medidas tendrá un significativo impacto en el manejo de los pacientes con EII. Estudios han demostrado que un modelo de atención integrado puede mejorar los resultados clínicos y psicosociales de estos pacientes, siendo incluso costo-efectivo 50 .…”

Section: Calidad De La Atenciónunclassified

Manejo integral de la enfermedad inflamatoria intestinal: más allá de una terapia farmacológica adecuada

Simian

Quera

2016

Rev. méd. Chile

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“…Compliance with recommended IBD care processes and quality measures are better in an IBD center [16]. Providing the patient and referring physician with a direct dial contact number to the IBD center and IBD nurse specialist can result in decreased visits to the emergency room and improved triage of acutely ill patients [20]. In keeping with the biopsychosocial model, improvements in anxiety, depression, quality of life, and coping skills occur when psychotherapy is provided to IBD patients [15].…”

mentioning

confidence: 93%

“…These studies have shown that patients using an IBD center have decreased hospitalization rates, decreased length of stay and costs of hospitalizations when they occur, and decreased polypharmacy including less opiate and steroid use [15,[18][19][20]. Compliance with recommended IBD care processes and quality measures are better in an IBD center [16].…”

mentioning

confidence: 99%

Better together: improved care of the IBD patient using the multi-disciplinary IBD center

Koltun

2017

Expert Review of Gastroenterology & Hepatology

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A chronic care model significantly decreases costs and healthcare utilisation in patients with inflammatory bowel disease

Abstract: Healthcare utilisation and disease burden in IBD decreased significantly since introducing an IBDS. These data suggest that proactive management improved outcomes. Contact with a gastroenterologist and IBDS seemed to give best results.

Cited by 104 publications

References 21 publications

A dedicated inflammatory bowel disease service quantitatively and qualitatively improves outcomes in less than 18 months: a prospective cohort study in a large metropolitan centre

A dedicated inflammatory bowel disease service quantitatively and qualitatively improves outcomes in less than 18 months: a prospective cohort study in a large metropolitan centre

Manejo integral de la enfermedad inflamatoria intestinal: más allá de una terapia farmacológica adecuada

Better together: improved care of the IBD patient using the multi-disciplinary IBD center

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