Characterizing the Posttransfer Period Among Patients with Pediatric Onset IBD: The Impact of Academic Versus Community Adult Care on Emergent Health Resource Utilization

• Published in: Inflammatory bowel diseases 2017-09, Vol.23 (9), p.1483-1491
• Main Authors: Bollegala, Natasha, Benchimol, Eric I, Griffiths, Anne M, Kovacs, Adrienne, Steinhart, Allan H, Zhao, Xinbei, Nguyen, Geoffrey C
• Format: Article
• Language: English
• ISSN: 1078-0998; 1536-4844
• DOI: 10.1097/MIB.0000000000001200

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. The purpose of this study was to determine the impact of posttransfer health care setting (academic versus community gastroenterologist) on emergent health resource utilization. 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. 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. Posttransfer health care setting does not seem to significantly impact emergent health resource utilization in the posttransfer period.