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Establishing an integrated gastroenterology service between a medical center and the community

World Journal of Gastroenterology 2015年第7期21卷 2152-2158页

作者： Yaron Niv Ram Dickman Zohar Levi Gadi Neumann Dorit Ehrlich Haim Bitterman Jacob Dreiher Arnon Cohen Doron Comaneshter eyran halpern Rabin Medical Center Clalit Health Services Tel Aviv University Dan-Petach Tikva District Clalit Health Services General Management Clalit Health Services

AIM:To combine community and hospital services inorder to enable improvements in patient management,an integrated gastroenterology service(IGS)was ***:Referral patterns to specialist clinics were optimized;open access route for endoscopic procedures(including esophago-gastro-duodenoscopy,sigmoidoscopy and colonoscopy)was established;family physicians’knowledge and confidence were enhanced;direct communication lines between experts and primary care physicians were *** education,guidelines and agreed instructions for referral were promoted by the *** quality indicators were developed by the Delphi method,rigorously designed and regularly *** was assessed by comparing 2010,2011 and 2012 ***:An integrated delivery system in a specific medical field may provide a solution to a fragmented healthcare system impaired by a lack of *** this paper we describe a new integrated gastroenterology service established in April *** time for procedures decreased:3 mo in April 30th 2010 to 3 wk in April 30th 2011and stayed between 1-3 wk till December 30th *** cost for patient’s visit decreased from 691 to638 NIS(a decrease of 7.6%).Six health indicators were improved significantly comparing 2010 to 2012,2.5%to 67.5%:Bone densitometry for patients with inflammatory bowel disease,preventive medications for high risk patients on aspirin/NSAIDs,colonoscopy following positive fecal occult blood test,gastroscopy in Barrett’s esophagus,documentation of family history of colorectal cancer,and colonoscopy in patients with a family history of colorectal ***:Establishment of an IGS was found to effectively improve quality of care,while being costeffective.

关键词： Gastroenterology Direct referral Endoscopy Communi

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