TY - JOUR
T1 - Characterizing the Posttransfer Period among Patients with Pediatric Onset IBD
T2 - The Impact of Academic Versus Community Adult Care on Emergent Health Resource Utilization
AU - Bollegala, Natasha
AU - Benchimol, Eric I.
AU - Griffiths, Anne M.
AU - Kovacs, Adrienne
AU - Steinhart, Allan H.
AU - Zhao, Xinbei
AU - Nguyen, Geoffrey C.
N1 - Publisher Copyright:
© 2017 Crohn's & Colitis Foundation.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background: Patients diagnosed with inflammatory bowel disease (IBD) during childhood require transfer to an adult gastroenterologist, in Ontario usually just before their 18th birthday. Pediatric onset IBD is a complex phenotype with demonstrated noncompliance risk that may require targeted measures to optimize health care outcomes in the adult care setting. Purpose: The purpose of this study was to determine the impact of posttransfer health care setting (academic versus community gastroenterologist) on emergent health resource utilization. Methods: This was a population-based retrospective cohort study using health care administrative data from Ontario, Canada. A cohort of patients with Pediatric onset IBD was identified and health resource utilization during a 2-year pretransfer period, transfer of care period and 2-year posttransfer period was analyzed. Posttransfer health care setting was defined as academic (i.e., gastroenterologists providing care in a university affiliated tertiary care center) versus community. A third comparator group, loss to follow-up, was also identified. The primary outcome of this study comprised emergency department utilization. Secondary outcomes included hospitalizations, surgeries, ambulatory visits, endoscopic investigations, and radiological investigations. Results: Overall, there were no significant differences found in emergency department use, ambulatory care visits (aside from the expected drop in the lost to follow-up group), hospitalizations, endoscopic procedures, or radiological procedures between exposure groups. Conclusions: Posttransfer health care setting does not seem to significantly impact emergent health resource utilization in the posttransfer period.
AB - Background: Patients diagnosed with inflammatory bowel disease (IBD) during childhood require transfer to an adult gastroenterologist, in Ontario usually just before their 18th birthday. Pediatric onset IBD is a complex phenotype with demonstrated noncompliance risk that may require targeted measures to optimize health care outcomes in the adult care setting. Purpose: The purpose of this study was to determine the impact of posttransfer health care setting (academic versus community gastroenterologist) on emergent health resource utilization. Methods: This was a population-based retrospective cohort study using health care administrative data from Ontario, Canada. A cohort of patients with Pediatric onset IBD was identified and health resource utilization during a 2-year pretransfer period, transfer of care period and 2-year posttransfer period was analyzed. Posttransfer health care setting was defined as academic (i.e., gastroenterologists providing care in a university affiliated tertiary care center) versus community. A third comparator group, loss to follow-up, was also identified. The primary outcome of this study comprised emergency department utilization. Secondary outcomes included hospitalizations, surgeries, ambulatory visits, endoscopic investigations, and radiological investigations. Results: Overall, there were no significant differences found in emergency department use, ambulatory care visits (aside from the expected drop in the lost to follow-up group), hospitalizations, endoscopic procedures, or radiological procedures between exposure groups. Conclusions: Posttransfer health care setting does not seem to significantly impact emergent health resource utilization in the posttransfer period.
KW - adult
KW - health resource utilization
KW - inflammatory bowel disease
KW - pediatric
KW - transition
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U2 - 10.1097/MIB.0000000000001200
DO - 10.1097/MIB.0000000000001200
M3 - Article
C2 - 28816756
AN - SCOPUS:85028339657
SN - 1078-0998
VL - 23
SP - 1483
EP - 1491
JO - Inflammatory Bowel Diseases
JF - Inflammatory Bowel Diseases
IS - 9
ER -