Natasha Bollegala1, Eric I Benchimol, Anne M Griffiths, Adrienne Kovacs, Allan H Steinhart, Xinbei Zhao, Geoffrey C Nguyen. 1. *Division of Gastroenterology, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; †Department of Pediatrics, Children's Hospital of Eastern Ontario, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada; ‡Sick Kids, Division of Gastroenterology Hepatology and Nutrition, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; §Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon; ‖Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Toronto, Ontario, Canada; and ¶Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Abstract
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.
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.
Authors: Nancy Fu; Natasha Bollegala; Kevan Jacobson; Karen I Kroeker; Karen Frost; Waqqas Afif; Wael El-Matary; Sharyle A Fowler; Anne M Griffiths; Hien Q Huynh; Prévost Jantchou; Ahmer Karimuddin; Geoffrey C Nguyen; Anthony R Otley; Christina Pears; Cynthia H Seow; Alene Toulany; Claudia Tersigni; Joanne Tignanelli; John K Marshall; Monica Boctor; Tawnya Hansen; Chandni Pattni; Andrew Wong; Eric I Benchimol Journal: J Can Assoc Gastroenterol Date: 2022-03-26
Authors: Eric I Benchimol; Waqqas Afif; Sophie Plamondon; Dennis Newhook; Stuart G Nicholls; Dominique Lévesque Journal: J Can Assoc Gastroenterol Date: 2021-05-15