Health Economic Impact of a Multicenter Quality-of-Care Initiative for Reducing Unplanned Healthcare Utilization Among Patients With Inflammatory Bowel Disease

Almario, Christopher V.; Kogan, Lawrence; Deen, Welmoed K. van; Scott, Frank I.; Singh, Siddharth; Hou, Jason K.; Lum, Donald; Aguilar, Humberto; Betteridge, John; Flynn, Ann D.; Gerich, Mark E.; Kaufman, Lia; Mattar, Mark; Mize, Carrie; Ostrov, Arthur; Shah, Samir A.; Younes, Ziad; Weaver, Sarah; Heller, Caren; Siegel, Corey A.; Melmed, Gil Y.

doi:10.14309/ajg.0000000000001540

Cited by 6 publications

(6 citation statements)

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“…This engagement was ultimately shown to be an independent predictor of successful improvement. In a cost-effectiveness evaluation using Markov decision models, the health economic impact of participation in this BTS demonstrated overall cost savings (21).…”

Section: Discussionmentioning

confidence: 99%

Quality of Care Program Reduces Unplanned Health Care Utilization in Patients With Inflammatory Bowel Disease

et al. 2021

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There is significant variation in processes and outcomes of care for patients with inflammatory bowel disease (IBD), suggesting opportunities to improve quality of care. We aimed to determine whether a structured quality of care program can improve IBD outcomes, including the need for unplanned health care utilization. METHODS:We used a structured approach to improve adult IBD care in 27 community-based gastroenterology practices and academic medical centers. Patient-reported outcomes (PRO) and health care utilization were collected at clinical visits. Outcomes were monitored monthly using statistical process control charts; improvement was defined by special cause (nonrandom) variation over time. Multivariable logistic regression was applied to patient-level data. Nineteen process changes were offered to improve unplanned health care utilization. Ten outcomes were assessed, including disease activity, remission status, urgent care need, recent emergency department use, hospitalizations, computed tomography scans, health confidence, corticosteroid or opioid use, and clinic phone calls. RESULTS:We collected data prospectively from 20,382 discrete IBD visits. During the 15-month project period, improvement was noted across multiple measures, including need for urgent care, hospitalization, steroid use, and opioid utilization. Adjusted multivariable modeling showed significant improvements over time across multiple outcomes including urgent care need, health confidence, emergency department utilization, hospitalization, corticosteroid use, and opioid use. Attendance at monthly coached webinars was associated with improvement.

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Section: Discussionmentioning

confidence: 99%

Quality of Care Program Reduces Unplanned Health Care Utilization in Patients With Inflammatory Bowel Disease

et al. 2021

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“…Finally, the CFLN is primed to move beyond a focus on “process” outcomes toward impacting health and equity metrics. Other networks have evaluated their impact in novel ways not yet explored by the CFLN 11,13,42‐44 . The CFLN may consider: deploying robust research methods (eg, a priori comparator groups with different tiers of interventions, stepped wedge designs, 45 and regression discontinuity designs 46 ) to evaluate CFLN innovations; using network analysis to identify and leverage critical nodes and connectors within the CFLN; identifying novel contributions that influence real‐world practice and research; and measuring value of results using economic analyses.…”

Section: Discussionmentioning

confidence: 99%

“…Other networks have evaluated their impact in novel ways not yet explored by the CFLN. 11 , 13 , 42 , 43 , 44 The CFLN may consider: deploying robust research methods (eg, a priori comparator groups with different tiers of interventions, stepped wedge designs, 45 and regression discontinuity designs 46 ) to evaluate CFLN innovations; using network analysis to identify and leverage critical nodes and connectors within the CFLN; identifying novel contributions that influence real‐world practice and research; and measuring value of results using economic analyses.…”

Section: Discussionmentioning

confidence: 99%

“…Although networks vary in form, size, shape and scope, they commonly: foster collaboration between healthcare professionals, patients and families, and researchers; connect people across geographic regions and clinical disciplines to share knowledge, resources, and best practices; drive goal‐directed actions toward a shared vision and mission; and provide systems for data sharing and knowledge dissemination. Participation in a learning health network can improve health outcomes 10‐15 …”

Section: Introductionmentioning

confidence: 99%

“…Participation in a learning health network can improve health outcomes. [10][11][12][13][14][15] The Cystic Fibrosis (CF) Care Center Network (CCN), accredited by the US CF Foundation (CFF), includes 286 programs that deliver care to nearly 40 000 patients. [16][17][18][19] Patient-level process and outcome measures are captured during all clinical encounters and entered into the CFF Patient Registry (CFFPR).…”

Section: Introductionmentioning

confidence: 99%

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The Cystic Fibrosis Learning Network: A mixed methods evaluation of program goals, attributes, and impact

Citters

Buus‐Frank

King

et al. 2022

Learning Health Systems

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Introduction:The Cystic Fibrosis (CF) Foundation sponsored the design, pilot testing, and implementation of the CF Learning Network (CFLN) to explore how the Foundation's Care Center Network (CCN) could become a learning health system. Six years after the design, the Foundation commissioned a formative mixed methods evaluation of the CFLN to assess: CFLN participants' understanding of program goals, attributes, and perceptions of current and future impact.Methods: We performed semi-structured interviews with CFLN participants to identify perceived goals, attributes, and impact of the network. Following thematic analyses, we developed and distributed a survey to CFLN members and a matched sample of CCN programs to understand whether the themes were unique to the CFLN.Results: Interviews with 24 CFLN participants were conducted. Interviewees identified the primary CFLN goal as improving outcomes for people living with CF, with secondary goals of providing training in quality improvement (QI), creating a learning community, engaging all stakeholders in improvement, and spreading best practices to the CCN. Project management, use of data, common QI methods, and the learning community were seen as critical to success. Survey responses were collected from 103 CFLN members and 25 CCN members. The data revealed that CFLN respondents were more likely than CCN respondents to connect with other CF programs, routinely use data for QI, and engage patient and family partners in QI.Conclusions: Our study suggests that the CFLN provides value beyond that achieved by the CCN. Key questions remain about whether spread of the CFLN could improve outcomes for more people living with CF.

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Quality in Inflammatory Bowel Disease

Fluxa,

Alahmad,

Farraye

2024

Quality in Gastroenterology

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Health Economic Impact of a Multicenter Quality-of-Care Initiative for Reducing Unplanned Healthcare Utilization Among Patients With Inflammatory Bowel Disease

Cited by 6 publications

References 13 publications

Quality of Care Program Reduces Unplanned Health Care Utilization in Patients With Inflammatory Bowel Disease

Quality of Care Program Reduces Unplanned Health Care Utilization in Patients With Inflammatory Bowel Disease

The Cystic Fibrosis Learning Network: A mixed methods evaluation of program goals, attributes, and impact

Quality in Inflammatory Bowel Disease

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