scholarly journals Management of Inflammatory Bowel Disease Patients With Clinical Care Pathways Reduces Emergency Department Utilization

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Ellina Lytvyak ◽  
Reed T Sutton ◽  
Levinus A Dieleman ◽  
Farhad Peerani ◽  
Richard N Fedorak ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Bowel Disease ◽  
Negative Binomial ◽  
Clinical Care ◽  
Emergency Department Utilization ◽  
Annual Number ◽  
Care Pathways ◽  
Inflammatory Bowel ◽  
Ed Visits

Abstract Background Standardizing care through pathways has the potential to reduce emergency department (ED) utilization. We developed and evaluated inflammatory bowel disease (IBD) care pathways for that purpose. Methods Over 2014–2016, IBD patients were retrospectively stratified into those managed and not managed by pathways. Patient data were extracted, and negative binomial regression used to predict the annual number of ED visits. Results There was a difference of 30.7 ED visits/100 patients between managed and nonmanaged at 12 months (P < 0.001). The incidence rate ratio of total ED visits occurring annually was 0.750 (P = 0.008). Conclusions Management with IBD care pathways reduces ED utilization.

Su1857 - Emergency Department Utilization for Inflammatory Bowel Disease from 2006-2014

2018 ◽  
Vol 154 (6) ◽  
pp. S-609
Author(s):  
Sarah Ballou ◽  
William Hirsch ◽  
Prashant Singh ◽  
Vikram Rangan ◽  
Judy Nee ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Bowel Disease ◽  
Emergency Department Utilization ◽  
Inflammatory Bowel

scholarly journals The Impact of Private Insurance Access on Nonurgent Inflammatory Bowel Disease-Related Emergency Department Use

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Natasha Bollegala ◽  
Geoffrey C Nguyen
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Bowel Disease ◽  
Private Insurance ◽  
Urban Setting ◽  
Secondary Outcome ◽  
Linear Regression Models ◽  
Inflammatory Bowel ◽  
Ed Visits ◽  
The Impact

Abstract Background Inflammatory bowel disease (IBD)-related Emergency Department (ED) visits are a costly component to current healthcare expenditures. Patients who are discharged directly from the ED for nonurgent issues (aka “treat and release” ED visits) present an opportunity for quality improvement. Purpose To determine the impact of private insurance on IBD-related treat and release ED visits. The secondary outcome was cost per IBD-related ED visit. Methodology A retrospective cohort study was performed on the 2006 Nationwide Emergency Department Sample (NEDS). Comparisons were made between patients with access to private insurance vs those without. Multivariable survey-weighted logistic and linear regression models with clustering by hospital were created for the primary and secondary outcomes, respectively. Results In total, 19,324 patient encounters were included in the stratified analytic sample. Of these, 9272 (47.98%) patients reported private insurance as their primary payment method. An additional 10,052 (52.02%) patients reported an alternative payment form. The private insurance group was statistically younger, less likely to reside in an urban setting and had more representation within the highest income quartile. The OR of a treat and release ED visit was 1.47 (95% confidence interval 1.34–1.62) for no private insurance compared to private insurance. On average, the cost per ED visit of patients without private insurance was $214.80 ± 48.48, P < 0.001 less than those with private insurance. Conclusions Lack of private insurance is an important predictor of IBD-related treat and release ED visits.

scholarly journals Lactobacillus Reuteri DSM 17938 (Limosilactobacillus reuteri) in Diarrhea and Constipation: Two Sides of the Same Coin?

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 643
Author(s):  
Angela Saviano ◽  
Mattia Brigida ◽  
Alessio Migneco ◽  
Gayani Gunawardena ◽  
Christian Zanza ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Human Health ◽  
Bowel Disease ◽  
Chronic Constipation ◽  
Lactobacillus Reuteri ◽  
Current Knowledge ◽  
Gastrointestinal Symptoms ◽  
Inflammatory Bowel

Background and Objectives: Lactobacillus reuteri DSM 17938 (L. reuteri) is a probiotic that can colonize different human body sites, including primarily the gastrointestinal tract, but also the urinary tract, the skin, and breast milk. Literature data showed that the administration of L. reuteri can be beneficial to human health. The aim of this review was to summarize current knowledge on the role of L. reuteri in the management of gastrointestinal symptoms, abdominal pain, diarrhea and constipation, both in adults and children, which are frequent reasons for admission to the emergency department (ED), in order to promote the best selection of probiotic type in the treatment of these uncomfortable and common symptoms. Materials and Methods: We searched articles on PubMed® from January 2011 to January 2021. Results: Numerous clinical studies suggested that L. reuteri may be helpful in modulating gut microbiota, eliminating infections, and attenuating the gastrointestinal symptoms of enteric colitis, antibiotic-associated diarrhea (also related to the treatment of Helicobacter pylori (HP) infection), irritable bowel syndrome, inflammatory bowel disease, and chronic constipation. In both children and in adults, L. reuteri shortens the duration of acute infectious diarrhea and improves abdominal pain in patients with colitis or inflammatory bowel disease. It can ameliorate dyspepsia and symptoms of gastritis in patients with HP infection. Moreover, it improves gut motility and chronic constipation. Conclusion: Currently, probiotics are widely used to prevent and treat numerous gastrointestinal disorders. In our opinion, L. reuteri meets all the requirements to be considered a safe, well-tolerated, and efficacious probiotic that is able to contribute to the beneficial effects on gut-human health, preventing and treating many gastrointestinal symptoms, and speeding up the recovery and discharge of patients accessing the emergency department.

scholarly journals Public versus Private Drug Insurance and Outcomes of Patients Requiring Biologic Therapies for Inflammatory Bowel Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Amir Rumman ◽  
Roberto Candia ◽  
Justina J. Sam ◽  
Kenneth Croitoru ◽  
Mark S. Silverberg ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Emergency Department Visits ◽  
Drug Coverage ◽  
Timely Access ◽  
Inflammatory Bowel ◽  
Ed Visits ◽  
Insured Patients ◽  
Public Drug ◽  
Privately Insured

Background. Antitumor necrosis factor (anti-TNF) therapy is a highly effective but costly treatment for inflammatory bowel disease (IBD).Methods. We conducted a retrospective cohort study of IBD patients who were prescribed anti-TNF therapy (2007–2014) in Ontario. We assessed if the insurance type was a predictor of timely access to anti-TNF therapy and nonroutine health utilization (emergency department visits and hospitalizations).Results. There were 268 patients with IBD who were prescribed anti-TNF therapy. Public drug coverage was associated with longer median wait times to first dose than private one (56 versus 35 days,P=0.002). After adjusting for confounders, publicly insured patients were less likely to receive timely access to anti-TNF therapy compared with those privately insured (adjusted hazard ratio, 0.66; 95% CI: 0.45–0.95). After adjustment for demographic and clinical characteristics, publicly funded subjects were more than 2-fold more likely to require hospitalization (incidence rate ratio [IRR], 2.30; 95% CI: 1.19–4.43) and ED visits (IRR 2.42; 95% CI: 1.44–4.08) related to IBD.Conclusions. IBD patients in Ontario with public drug coverage experienced greater delays in access to anti-TNF therapy than privately insured patients and have a higher rate of hospitalizations and ED visits related to IBD.

1140 PATIENTS WITH INFLAMMATORY BOWEL DISEASE ARE FREQUENTLY PRESCRIBED OPIOID ANALGESICS WHEN DISCHARGED FROM THE EMERGENCY DEPARTMENT

2020 ◽  
Vol 158 (6) ◽  
pp. S-225-S-226
Author(s):  
Tarun Chhibba ◽  
Remo Panaccione ◽  
Cynthia H. Seow ◽  
Cathy Lu ◽  
Kerri L. Novak ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Bowel Disease ◽  
Opioid Analgesics ◽  
Inflammatory Bowel

Patient Experiences and Outcomes of a Telehealth Clinical Care Pathway for Postoperative Inflammatory Bowel Disease Patients

2020 ◽  
Vol 26 (7) ◽  
pp. 889-897
Author(s):  
Aria Zand ◽  
Audrey Nguyen ◽  
Zack Stokes ◽  
Welmoed van Deen ◽  
Amy Lightner ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Care Pathway ◽  
Clinical Care ◽  
Patient Experiences ◽  
Inflammatory Bowel ◽  
Clinical Care Pathway
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