Quality of care delivered to hospitalized inflammatory bowel disease patients

Abstract

Hospitalized patients with inflammatory bowel disease (IBD) are at high risk for morbidity, mortality, and health care utilization costs. While the literature on trends in hospitalization rates for this disease is conflicting, there does appear to be significant variation in the delivery of care to this complex group, which may be a marker of suboptimal quality of care. There is a need for improvement in identifying patients at risk for hospitalization in an effort to reduce admissions. Moreover, appropriate screening for a number of hospital acquired complications such as venous thromboembolism and Clostridium difficile infection is suboptimal. This review discusses areas of inpatient care for IBD patients that are in need of improvement and outlines a number of potential quality improvement initiatives such as pay-for-performance models, quality improvement frameworks, and healthcare information technology.

Keywords: Crohn’s disease; Hospitalization; Inflammatory bowel disease; Quality improvement; Ulcerative colitis

Core tip: Hospitalized patients with inflammatory bowel disease are at risk of harm and increased utilization of healthcare resources. Variation in the care delivered to these patients is common. There is room for improvement in the quality of care focusing on reducing admissions and identifying patients at risk for inpatient complications such as venous thromboembolism and Clostridium difficile infection. This review outlines several aspects of inpatient care in need of improvement and discusses a number of improvement strategies that have been implemented with potential to benefit both patients and providers.