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炎症性肠病结构化儿科至成人过渡的获益:TRANSIT 观察性研究。

Benefits of Structured Pediatric to Adult Transition in Inflammatory Bowel Disease: The TRANSIT Observational Study.

机构信息

University College London Hospitals NHS Foundation Trust.

Barts Health NHS Trust, London.

出版信息

J Pediatr Gastroenterol Nutr. 2022 Feb 1;74(2):208-214. doi: 10.1097/MPG.0000000000003244.

Abstract

OBJECTIVE

To evaluate the impact of structured transition from pediatric to adult inflammatory bowel disease (IBD) services on objective patient outcomes, including disease flares, admission rates, and healthcare resource use.

METHODS

A retrospective observational study in 11 United Kingdom gastroenterology centers. Transition patients attended ≥2 visits to the gastroenterology service with both pediatric and adult personnel jointly present; non-transition patients transferred to adult services without joint visits. Data were collected from medical records for the 12-month periods before and after the date of the first visit involving adult IBD services (index visit).

RESULTS

A total of 129 patients were included: 95 transition patients and 34 non-transition patients. In the 12 months post-index visit, transition patients had fewer disease flares (P  = 0.05), were more likely to be steroid-free (71% vs 41%, P < 0.05), and were less likely to have an emergency department visit leading to hospital admission (5% vs 18%, P < 0.05). During this period, the mean estimated overall cost of care per patient was £1644.22 in the transition group and £1827.32 in the non-transition group (P = 0.21).

CONCLUSION

Structured transition from pediatric to adult IBD care services was associated with positive and cost-neutral outcomes in patients with pediatric IBD.

摘要

目的

评估从儿科到成人炎症性肠病(IBD)服务的结构化过渡对客观患者结局的影响,包括疾病发作、住院率和医疗资源利用。

方法

在英国的 11 个胃肠病学中心进行的回顾性观察性研究。过渡患者参加了至少 2 次儿科和成人人员共同参与的胃肠病学服务就诊;非过渡患者在没有联合就诊的情况下转至成人服务。数据从病历中收集,包括在涉及成人 IBD 服务的首次就诊(索引就诊)之前和之后的 12 个月。

结果

共纳入 129 名患者:95 名过渡患者和 34 名非过渡患者。在索引就诊后的 12 个月内,过渡患者的疾病发作次数更少(P=0.05),更有可能无需使用类固醇(71%比 41%,P<0.05),并且不太可能因急诊就诊而导致住院(5%比 18%,P<0.05)。在此期间,过渡组每位患者的估计总护理费用平均为 1644.22 英镑,而非过渡组为 1827.32 英镑(P=0.21)。

结论

从儿科到成人 IBD 护理服务的结构化过渡与儿科 IBD 患者的积极和成本中性结果相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faae/8788940/b6ca5c8ed714/jpga-74-208-g001.jpg

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