在炎症性肠道疾病的提供者专业化:护理质量和结果
James D Lewis1, Colleen M Brensinger2, Lauren E Parlett3
1Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
胃肠科医生的专业化影响成人炎症肠病 (IBD) 护理,影响药物和程序的使用. 儿科IBD护理没有根据提供者重点显示出显著的变化.
科学领域:
- 胃肠病学 胃肠病学
- 临床实践变化 临床实践变化
- 炎症性肠病 (IBD) 管理管理
背景情况:
- 炎症性肠道疾病 (IBD) 的管理是复杂的,在患者护理方面有记录的变化.
- 这些实践差异的根本原因在很大程度上仍未被探索.
研究的目的:
- 调查IBD管理中的实践变化.
- 检查胃肠科医生对IBD的关注是否会影响治疗过程和临床结果.
主要方法:
- 使用非识别索赔数据 (2000-2020年) 进行回顾性队列研究.
- 分析了新诊断的IBD患者,基于提供者IBD访问比例 (>第90百分位).
- 使用调整后回归模型来评估与过程测量和临床结果的关联,包括随时间的变化.
主要成果:
- 在成年人中,以IBD为重点的提供者使用了更多的生物药物,组合疗法和诊断成像/内镜,对克罗恩病的梅萨拉的使用较少.
- 在提供者IBD重点和儿童的过程/结果措施之间没有发现显著的关联.
- 在后期的研究时代,生物使用增加,麻醉剂使用减少;住院和手术率与提供者关注度或时代无关.
结论:
- 提供者专业化影响成人炎症性肠道疾病的管理.
- 由于IBD的复杂性日益增加,可能需要新的策略来规范IBD护理.
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