Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Vienna, Austria.
Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria.
J Headache Pain. 2024 Aug 1;25(1):127. doi: 10.1186/s10194-024-01835-x.
Management of idiopathic intracranial hypertension (IIH) is complex requiring contributions from multiple specialized disciplines. In practice, this creates considerable organizational and communicational challenges. To meet those challenges, we established an interdisciplinary integrated outpatient clinic for IIH with a central coordination and a one-stop concept. Here, we aimed to evaluate effects of this one-stop concept on subjective patient satisfaction and economic outcome in patients with IIH.
In a retrospective cohort study, we compared the one-stop era with integrated care (IC, 1-JUL-2021 to 31-DEC-2022) to a reference group receiving standard care (SC, 1-JUL-2018 to 31-DEC-2019) regarding subjective patient satisfaction (assessed by the Vienna Patient Inventory). Multivariable binary linear regression models were used to adjust for confounders.
Baseline characteristics of the IC group (n = 85) and SC group (n = 81) were comparable (female: 90.6% vs. 90.1%; mean age: 33.6 vs. 32.8 years, educational level: ≥9 years of education 60.0% vs. 59.3%; located in Vienna 75.3% vs. 76.5%). Compared to SC, management within IC concept was associated with statistically significantly higher subjective patient satisfaction (beta = 0.93; p < 0.001) with the strongest effects observed in satisfaction with treatment accessibility and availability (beta = 2.05; p < 0.001). Subgroup analyses of patients with migration background and language barrier consistently indicated stronger effects of IC in these groups.
Interdisciplinary integrated management of IIH statistically significantly and clinically meaningfully improves patient satisfaction - particularly in socioeconomically underprivileged patient groups. Providing structured central coordination to facilitate and improve access to interdisciplinary management provides means to further improve outcome.
特发性颅内高压(IIH)的管理较为复杂,需要多个专业学科共同参与。实际上,这会带来相当大的组织和沟通挑战。为了应对这些挑战,我们建立了一个以 IIH 为中心的多学科综合门诊,提供集中协调和一站式服务。在此,我们旨在评估这种一站式服务对 IIH 患者主观满意度和经济结果的影响。
在回顾性队列研究中,我们将综合护理的一站式时代(IC,2021 年 7 月 1 日至 2022 年 12 月 31 日)与接受标准护理的参考组(SC,2018 年 7 月 1 日至 2019 年 12 月 31 日)进行比较,以评估主观患者满意度(采用维也纳患者清单评估)。使用多变量二项线性回归模型调整混杂因素。
IC 组(n=85)和 SC 组(n=81)的基线特征相似(女性:90.6%比 90.1%;平均年龄:33.6 岁比 32.8 岁,教育程度:≥9 年教育 60.0%比 59.3%;位于维也纳 75.3%比 76.5%)。与 SC 相比,IC 概念下的管理与统计学上显著更高的主观患者满意度相关(β=0.93;p<0.001),在治疗可及性和可用性满意度方面的影响最强(β=2.05;p<0.001)。具有移民背景和语言障碍的患者亚组分析一致表明,IC 在这些群体中的效果更强。
多学科综合管理 IIH 可显著且有临床意义地提高患者满意度,尤其是在社会经济地位较低的患者群体中。提供结构化的集中协调以促进和改善对多学科管理的访问,为进一步改善结果提供了手段。