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

Ellina Lytvyak; Reed T Sutton; Levinus A Dieleman; Farhad Peerani; Richard N Fedorak; Karen I Kroeker

doi:10.1093/crocol/otaa080

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

Crohns Colitis 360. 2020 Oct 13;2(4):otaa080. doi: 10.1093/crocol/otaa080. eCollection 2020 Oct.

Authors

Ellina Lytvyak¹, Reed T Sutton¹, Levinus A Dieleman¹, Farhad Peerani¹, Richard N Fedorak¹, Karen I Kroeker¹

Affiliation

¹ Division of Gastroenterology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

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.

Keywords: clinical care pathway; emergency department; healthcare utilization; inflammatory bowel disease.