Berry Sameer K, Melmed Gil Y
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Intest Res. 2018 Jan;16(1):43-47. doi: 10.5217/ir.2018.16.1.43. Epub 2018 Jan 18.
Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is a chronic, debilitating, and expensive condition affecting millions of people globally. There is significant variation in the quality of care for patients with IBD across North America, Europe, and Asia; this variation suggests poor quality of care due to overuse, underuse, or misuse of health services and disparity of outcomes. Several initiatives have been developed to reduce variation in care delivery and improve processes of care, patient outcomes, and reduced healthcare costs. These initiatives include the development of quality indicator sets to standardize care across organizations, and learning health systems to enable data sharing between doctors and patients, and sharing of best practices among providers. These programs have been variably successful in improving patient outcomes and reducing healthcare utilization. Further studies are needed to demonstrate the long-term impact and applicability of these efforts in different geographic areas around the world, as regional variations in patient populations, societal preferences, and costs should inform local quality improvement efforts.
炎症性肠病(IBD),包括克罗恩病和溃疡性结肠炎,是一种慢性、使人衰弱且费用高昂的疾病,全球数百万人受其影响。在北美、欧洲和亚洲,炎症性肠病患者的护理质量存在显著差异;这种差异表明,由于医疗服务的过度使用、使用不足或滥用以及结果的差异,护理质量较差。已经开展了多项举措来减少护理提供方面的差异,并改善护理流程、患者预后以及降低医疗成本。这些举措包括制定质量指标集以规范各机构之间的护理,以及建立学习型卫生系统以实现医生与患者之间的数据共享,以及提供者之间的最佳实践分享。这些项目在改善患者预后和减少医疗利用方面取得了不同程度的成功。需要进一步的研究来证明这些努力在世界不同地理区域的长期影响和适用性,因为患者群体、社会偏好和成本的区域差异应该为当地的质量改进工作提供参考。