28 Oct Patient-Centered Medical Home Improved Quality of Life in Inflammatory Bowel Disease
MedicalResearch.com Interview with:
Miguel Regueiro, M.D., AGAF, FACG, FACP
Professor of Medicine and Professor, Clinical and Translational Science
University of Pittsburgh School of Medicine
Senior Medical Lead of Specialty Medical Homes
University of Pittsburgh Medical Center
IBD Clinical Medical Director
Division of Gastroenterology, Hepatology, and Nutrition
Pittsburgh PA, 15213
MedicalResearch.com: What is the background for this study?
Response: The background for the study is that we created an Inflammatory Bowel Disease (IBD) patient centered medical home in conjunction with our UPMC Health Plan. The IBD medical home has been designated UPMC IBD Total Care and provides whole person care for patients with ulcerative colitis and Crohn’s disease. Unlike primary care medical homes, the gastroenterologist is the principle care provider in this specialty medical home model. We created this medical home to improve the IBD patient experience, provide high quality care, and decrease utilization and cost.
MedicalResearch.com: What are the main findings?
Response: The main findings of our study are that we exceeded our first year enrollment target of 300 (323) patients, improved quality of life, and decreased unplanned care.
We began enrolling patients on July 1, 2015 with an average of 29 new patients per month and 41 return visits per month. The median Quality of Life score, measured by the Short Form Inflammatory Disease Questionnaire (SIBDQ), for the cohort at enrollment was 31.2 (poor). By the end of Year 1 the median SIBDQ improved significantly by 9.1 points (40.3, p<0.001). The improvement in quality of life was rapid and was realized by the third visit in the medical home. Health care utilization was significantly reduced. For patients followed for at least 6 months in the medical home there was a significant decrease in ER visits (197 to 116, p =0.001) and hospitalizations (100 to 56, p < 0.005).
MedicalResearch.com: What should readers take away from your report?
Response: Healthcare reform has led to an emphasis on improved quality and value of care with reduction in cost. New models of care have emerged. The primary care medical home has been established for the past decade but specialty medical homes are novel. Specialists will need to play a larger role in these chronic disease models and gastroenterologists serve as principle care providers for such diseases as inflammatory bowel disease.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: There is future research potential in testing new models of team based care for chronic GI diseases. Studying the impact on total cost of care, leveraging of information technology, and models that scale medical delivery to these specialty diseases will be studied. Ultimately, the research will define which model(s) improve quality and value while decreasing cost.
MedicalResearch.com: Is there anything else you would like to add?
Response: We believe that our UPMC IBD medical home represents the first-of-its-kind payer-provider model of care in which a specialist provides principle care for a population of patients and works in conjunction with a Health Plan. The specialty medical home model presented in our research abstract at ACG will certainly not represent the final version of team-based care for IBD and will evolve into other healthcare delivery models over the coming years.
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Abstract presented at the 2016 ACG:
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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