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Gonczi L, Kurti Z, Golovics PA, Lovasz BD, Menyhart O, Seres A, Sumegi LD, Gal A, Ilias A, Janos P, Gecse KB, Bessisow T, Afif W, Bitton A, Vegh Z, Lakatos PL. Quality of care indicators in inflammatory bowel disease in a tertiary referral center with open access and objective assessment policies. Dig Liver Dis 2018; 50:37-41. [PMID: 29107471 DOI: 10.1016/j.dld.2017.09.137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/28/2017] [Accepted: 09/28/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND In the management of inflammatory bowel diseases, there is considerable variation in quality of care. AIMS The aim of this study was to evaluate structural, access/process components and outcome quality indicators in our tertiary referral IBD center. METHODS In the first phase, structural/process components were assessed, followed by the second phase of formal evaluation of access and management on a set of consecutive IBD patients with and without active disease (248CD/125UC patients, median age 35/39 years). RESULTS Structural/process components of our IBD center met the international recommendations. At or around the time of diagnosis usual procedures were full colonoscopy in all patients, with ileocolonoscopy/gastroscopy/CT/MRI in 81.8/45.5/66.1/49.6% of CD patients. A total of 86.7% of CD patients had any follow-up imaging evaluation or endoscopy. The median waiting time for non-emergency endoscopy/CT/MRI was 16/14/22 days. During the observational period patients with flares (CD/UC:50.6/54.6%) were seen by specialist at the IBD clinic within a median of 1day with same day laboratory assessment, abdominal US, CT scan/surgical consult and change in therapy if needed. Surgery and hospitalization rates were 20.1/1.4% and 17.3/3.2% of CD/UC patients. CONCLUSION Our results highlight that structural components and processes applied in our center are in line with international recommendations, including an open clinic concept and fast track access to specialist consultation, endoscopy and imaging.
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Affiliation(s)
- Lorant Gonczi
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Kurti
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | | | - Barbara Dorottya Lovasz
- First Department of Medicine, Semmelweis University, Budapest, Hungary; Faculty of Health Sciences, Department of Clinical Studies, Semmelweis University, Budapest, Hungary
| | - Orsolya Menyhart
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Anna Seres
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Liza Dalma Sumegi
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Alexander Gal
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Akos Ilias
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Papp Janos
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | | | - Talat Bessisow
- Division of Gastroenterology, McGill University, MUHC, Montreal General Hospital, Montreal, QC, Canada
| | - Waqqas Afif
- Division of Gastroenterology, McGill University, MUHC, Montreal General Hospital, Montreal, QC, Canada
| | - Alain Bitton
- Division of Gastroenterology, McGill University, MUHC, Montreal General Hospital, Montreal, QC, Canada
| | - Zsuzsanna Vegh
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Peter Laszlo Lakatos
- First Department of Medicine, Semmelweis University, Budapest, Hungary; Division of Gastroenterology, McGill University, MUHC, Montreal General Hospital, Montreal, QC, Canada.
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