Joseph D Feuerstein1, Natalia E Castillo2, Sana S Siddique3, Jeffrey J Lewandowski4, Kathy Geissler5, Manuel Martinez-Vazquez6, Chandrashekhar Thukral7, Daniel A Leffler2, Adam S Cheifetz2. 1. Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. Electronic address: jfeuerst@bidmc.harvard.edu. 2. Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 3. Department of Medicine, Mt Auburn Hospital, Harvard Medical School, Boston, Massachusetts. 4. Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 5. Rockford Gastroenterology Associates, Rockford, Illinois. 6. Gastroenterology Service, Dr. José Eleuterio González University Hospital, Monterrey, Nuevo León, Mexico. 7. University of Illinois at Chicago College of Medicine, Rockford, Illinois; Rockford and Rockford Gastroenterology Associates, Rockford, Illinois.
Abstract
BACKGROUND & AIMS: Quality measures are used to standardize health care and monitor quality of care. In 2011, the American Gastroenterological Association established quality measures for inflammatory bowel disease (IBD), but there has been limited documentation of compliance from different practice settings. METHODS: We reviewed charts from 367 consecutive patients with IBD seen at academic practices, 217 patients seen at community practices, and 199 patients seen at private practices for compliance with 8 outpatient measures. Records were assessed for IBD history, medications, comorbidities, and hospitalizations. We also determined the number of patient visits to gastroenterologists in the past year, whether patients had a primary care physician at the same institution, and whether they were seen by a specialist in IBD or in conjunction with a trainee, and reviewed physician demographics. A univariate and multivariate statistical analysis was performed to determine which factors were associated with compliance of all core measures. RESULTS: Screening for tobacco abuse was the most frequently assessed core measure (89.6% of patients; n = 701 of 783), followed by location of IBD (80.3%; n = 629 of 783), and assessment for corticosteroid-sparing therapy (70.8%; n = 275 of 388). The least-frequently evaluated measures were pneumococcal immunization (16.7% of patients; n = 131 of 783), bone loss (25%; n = 126 of 505), and influenza immunization (28.7%; n = 225 of 783). Only 5.8% of patients (46 of 783) had all applicable core measures documented (24 in academic practice, none in clinical practice, and 22 in private practice). In the multivariate model, year of graduation from fellowship (odds ratio [OR], 2.184; 95% confidence interval [CI], 1.522-3.134; P < .001), year of graduation from medical school (OR, 0.500; 95% CI, 0.352-0.709; P < .001), and total number of comorbidities (OR, 1.089; 95% CI, 1.016-1.168; P = .016) were associated with compliance with all core measures. CONCLUSIONS: We found poor documentation of IBD quality measures in academic, clinical, and private gastroenterology practices. Interventions are necessary to improve reporting of quality measures.
BACKGROUND & AIMS: Quality measures are used to standardize health care and monitor quality of care. In 2011, the American Gastroenterological Association established quality measures for inflammatory bowel disease (IBD), but there has been limited documentation of compliance from different practice settings. METHODS: We reviewed charts from 367 consecutive patients with IBD seen at academic practices, 217 patients seen at community practices, and 199 patients seen at private practices for compliance with 8 outpatient measures. Records were assessed for IBD history, medications, comorbidities, and hospitalizations. We also determined the number of patient visits to gastroenterologists in the past year, whether patients had a primary care physician at the same institution, and whether they were seen by a specialist in IBD or in conjunction with a trainee, and reviewed physician demographics. A univariate and multivariate statistical analysis was performed to determine which factors were associated with compliance of all core measures. RESULTS: Screening for tobacco abuse was the most frequently assessed core measure (89.6% of patients; n = 701 of 783), followed by location of IBD (80.3%; n = 629 of 783), and assessment for corticosteroid-sparing therapy (70.8%; n = 275 of 388). The least-frequently evaluated measures were pneumococcal immunization (16.7% of patients; n = 131 of 783), bone loss (25%; n = 126 of 505), and influenza immunization (28.7%; n = 225 of 783). Only 5.8% of patients (46 of 783) had all applicable core measures documented (24 in academic practice, none in clinical practice, and 22 in private practice). In the multivariate model, year of graduation from fellowship (odds ratio [OR], 2.184; 95% confidence interval [CI], 1.522-3.134; P < .001), year of graduation from medical school (OR, 0.500; 95% CI, 0.352-0.709; P < .001), and total number of comorbidities (OR, 1.089; 95% CI, 1.016-1.168; P = .016) were associated with compliance with all core measures. CONCLUSIONS: We found poor documentation of IBD quality measures in academic, clinical, and private gastroenterology practices. Interventions are necessary to improve reporting of quality measures.
Authors: Florian Rieder; Benjamin L Cohen; Jennifer L Dotson; Meenakshi Bewtra; Ashwin N Ananthakrishnan; Tolulope O Falaiye; Christina Y Ha Journal: Inflamm Bowel Dis Date: 2016-06 Impact factor: 5.325
Authors: Joseph D Feuerstein; Konstantinos Papamichael; Sara Popejoy; Adam Nadelson; Jeffrey J Lewandowski; Kathy Geissler; Manuel Martinez-Vazquez; Daniel A Leffler; Kim Ariyabuddhiphongs; Chandrashekhar Thukral; Adam S Cheifetz Journal: Dig Dis Sci Date: 2017-11-17 Impact factor: 3.199
Authors: Joseph D Feuerstein; Thomas Curran; Michael Alosilla; Thomas Cataldo; Kenneth R Falchuk; Vitaliy Poylin Journal: Dig Dis Sci Date: 2018-01-20 Impact factor: 3.199
Authors: Robert Battat; Jonathan S Galati; Dana Lukin; Fatiha Chabouni; Robbyn Sockolow; Jeff Carter; Kristina Fajardo; Stevie Yang; Jenna Reich; Vinita Jacobs; Meira Abramowitz; Anand Kumar; Paul Christos; Randy S Longman; Robert Burakoff; Laura Simone; Tamar Sapir; Carl V Crawford; Ellen J Scherl Journal: J Clin Gastroenterol Date: 2022-03-01 Impact factor: 3.062