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Transitions of care across hospital settings in patients with inflammatory bowel disease

World Journal of Gastroenterology 2019年第17期25卷 2122-2132页

作者： leigh r warren Jonathan M Clarke Sonal Arora Mauricio Barahona Naila Arebi Ara Darzi Patient Safety Translational research Centre Imperial College London Department of Surgery and Cancer Imperial College London Centre for Health Policy Imperial College London Centre for Mathematics of Precision HealthcareImperial College London Department of Biostatistics Harvard University Department of Mathematics Imperial College London Department of Gastroenterology St.Marks Academic Institute

BACKGrOUND Inflammatory bowel disease(IBD) is a chronic, inflammatory disorder characterised by both intestinal and extra-intestinal pathology. Patients may receive both emergency and elective care from several providers, often in different hospital settings. Poorly managed transitions of care between providers can lead to inefficiencies in care and patient safety issues. To ensure that the sharing of patient information between providers is appropriate, timely, accurate and secure, effective data-sharing infrastructure needs to be developed. To optimise inter-hospital data-sharing for IBD patients, we need to better understand patterns of hospital encounters in this *** To determine the type and location of hospital services accessed by IBD patients in *** was a retrospective observational study using Hospital Episode Statistics, a large administrative patient data set from the National Health Service in *** patients with a diagnosis of IBD following admission to hospital were followed over a 2-year period to determine the proportion of care accessed at the same hospital providing their outpatient IBD care, defined as their ‘home provider'. Secondary outcome measures included the geographic distribution of patient-sharing, regional and age-related differences in accessing services, and type and frequency of outpatient ***95055 patients accessed hospital services on 1760156 occasions over a 2-year follow-up period. The proportion of these encounters with their identified IBD‘home provider' was 73.3%, 87.8% and 83.1% for accident and emergency,inpatient and outpatient encounters respectively. Patients living in metropolitan centres and younger patients were less likely to attend their ‘home provider' for hospital services. The most commonly attended specialty services were gastroenterology, general surgery and *** Transitions of care between secondary care settings are common for patients with IBD. E

关键词： Inflammatory bowel disease Crohn's disease Ulcerative colitis Transitions of care Continuity of care Fragmentation Multi-morbidity

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