Michel Hilary K, Boyle Brendan, David Jennie, Donegan Amy, Drobnic Barb, Kren Courtney, Maltz Ross M, McKillop Hannah N, McNicol Megan, Oates Melanie, Dotson Jennifer L
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.
Department of Pediatrics, The Ohio State Wexner Medical Center, Columbus, OH, USA.
Inflamm Bowel Dis. 2022 Sep 1;28(9):1420-1429. doi: 10.1093/ibd/izab238.
Care for patients with inflammatory bowel disease (IBD) can be complex and costly. Care delivery models to address these challenges and improve care quality are essential. The patient-centered medical home (PCMH), which was developed in the primary care setting, has recently been applied successfully to the adult IBD population. Following the tenets of the PCMH, this specialty medical home (SMH) emphasizes team-based care that is accessible, comprehensive, patient/family-centered, coordinated, compassionate, and continuous and has demonstrated improved patient outcomes. Children and young adults with IBD have equally complex care needs, with additional challenges not faced by the adult population such as growth, physical and psychosocial development, and transition of care from pediatric to adult providers. Thus, we advocate that the components of the PCMH are equally-if not more-important in caring for the pediatric patient population. In this article, we review what is known about the application of the PCMH model in adult IBD care, describe care delivery within the Center for Pediatric and Adolescent IBD at Nationwide Children's Hospital as an example of a pediatric IBD medical home, and propose a research agenda to further the development and dissemination of comprehensive care delivery for children and adolescents with IBD.
炎症性肠病（IBD）患者的护理可能复杂且成本高昂。应对这些挑战并提高护理质量的护理提供模式至关重要。以初级保健为背景发展起来的以患者为中心的医疗之家（PCMH），最近已成功应用于成年IBD患者群体。遵循PCMH的原则，这种专科医疗之家（SMH）强调基于团队的护理，这种护理具有可及性、全面性、以患者/家庭为中心、协调性、同情心和连续性，并已证明能改善患者预后。患有IBD的儿童和青少年同样有复杂的护理需求，还面临成年人群体未遇到的额外挑战，如生长发育、身体和心理社会发展以及从儿科护理向成人护理提供者的过渡。因此，我们主张PCMH的组成部分在照顾儿科患者群体方面同样重要——如果不是更重要的话。在本文中，我们回顾了关于PCMH模式在成年IBD护理中的应用的已知情况，描述了作为儿科IBD医疗之家示例的全国儿童医院儿科和青少年IBD中心的护理提供情况，并提出了一项研究议程，以进一步推动针对患有IBD的儿童和青少年的综合护理提供的发展和传播。
