University College London Hospitals NHS Foundation Trust.
Barts Health NHS Trust, London.
J Pediatr Gastroenterol Nutr. 2022 Feb 1;74(2):208-214. doi: 10.1097/MPG.0000000000003244.
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.
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).
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).
Structured transition from pediatric to adult IBD care services was associated with positive and cost-neutral outcomes in patients with pediatric IBD.
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。
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。
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)。
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。