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

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Title: Transitions of care across hospital settings in patients with inflammatory bowel disease
Authors: Warren, L
Clarke, J
Arora, S
Barahona, M
Arebi, N
Darzi, A
Item Type: Journal Article
Abstract: 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 group. AIM To determine the type and location of hospital services accessed by IBD patients in England. METHODS This was a retrospective observational study using Hospital Episode Statistics, a large administrative patient data set from the National Health Service in England. Adult 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 encounters. RESULTS Of 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 ophthalmology. CONCLUSION Transitions of care between secondary care settings are common for patients with IBD. Effective systems of data-sharing and care integration are essential to providing safe and effective care for patients. Geographic and age-related patterns of care transitions identified in this study may be used to guide interventions aimed at improving continuity of care.
Editors: Yan, J-P
Li, X
Issue Date: 7-May-2019
Date of Acceptance: 22-Feb-2019
URI: http://hdl.handle.net/10044/1/68068
DOI: https://dx.doi.org/10.3748/wjg.v25.i17.2122
ISSN: 1007-9327
Publisher: Baishideng Publishing Group Co. Limited
Start Page: 2122
End Page: 2132
Journal / Book Title: World Journal of Gastroenterology
Volume: 25
Issue: 17
Copyright Statement: ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Sponsor/Funder: National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
Engineering & Physical Science Research Council (EPSRC)
National Institute of Health Research
Funder's Grant Number: n/a
RDB04
EP/N014529/1
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
Inflammatory bowel disease
Crohn's disease
Ulcerative colitis
Transitions of care
Continuity of care
Fragmentation
Multi-morbidity
EXTRAINTESTINAL MANIFESTATIONS
INTEROPERABILITY
PREVALENCE
QUALITY
Continuity of care
Crohn’s disease
Fragmentation
Inflammatory bowel disease
Multi-morbidity
Transitions of care
Ulcerative colitis
Inflammatory Bowel Diseases
Crohn Disease
Colitis, Ulcerative
Transitional Care
Patient Safety
Continuity of Patient Care
Morbidity
1103 Clinical Sciences
Gastroenterology & Hepatology
Publication Status: Published
Conference Place: USA
Open Access location: https://www.f6publishing.com/ArticleInPressDetail?id=45823
Article Number: 45823
Online Publication Date: 2019-05-07
Appears in Collections:Division of Surgery
Mathematics
Applied Mathematics and Mathematical Physics
Faculty of Medicine
Faculty of Natural Sciences



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