Niv Y, Dickman R, Levi Z, Neumann G, Ehrlich D, Bitterman H, Dreiher J, Cohen A, Comaneshter D, Halpern E. Establishing an integrated gastroenterology service between a medical center and the community. World J Gastroenterol 2015; 21(7): 2152-2158 [PMID: 25717251 DOI: 10.3748/wjg.v21.i7.2152]
Corresponding Author of This Article
Yaron Niv, MD, AGAF, FACG, Professor, Rabin Medical Center, Clalit Health Services, Tel Aviv University, P.O. Box 39040, Petach Tikva 49100, Israel. yniv@clalit.org.il
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Feb 21, 2015; 21(7): 2152-2158 Published online Feb 21, 2015. doi: 10.3748/wjg.v21.i7.2152
Establishing an integrated gastroenterology service between a medical center and the community
Yaron Niv, Ram Dickman, Zohar Levi, Gadi Neumann, Dorit Ehrlich, Haim Bitterman, Jacob Dreiher, Arnon Cohen, Doron Comaneshter, Eyran Halpern
Yaron Niv, Ram Dickman, Zohar Levi, Gadi Neumann, Eyran Halpern, Rabin Medical Center, Clalit Health Services, Tel Aviv University, Petach Tikva 49100, Israel
Dorit Ehrlich, Dan - Petach Tikva District, Clalit Health Services, Petach Tikva 49100, Israel
Haim Bitterman, Jacob Dreiher, Arnon Cohen, Doron Comaneshter, General Management, Clalit Health Services, Tel Aviv-Yafo 6997801, Israel
Author contributions: Niv Y designed research, collected and analyzed data, analyzed and wrote the manuscript; Dickman R performed research and helped in writing the paper; Levi Z contributed new clinical approaches; Neumann G, Ehrlich D, Bitterman H and Halpern E designed research; Dreiher J designed research and quality indicators; Cohen A designed quality indicators; Comaneshter D designed quality indicators and performed statistics.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yaron Niv, MD, AGAF, FACG, Professor, Rabin Medical Center, Clalit Health Services, Tel Aviv University, P.O. Box 39040, Petach Tikva 49100, Israel. yniv@clalit.org.il
Telephone: +972-3-9377237 Fax: +972-3-9210313
Received: May 31, 2014 Peer-review started: June 3, 2014 First decision: July 9, 2014 Revised: July 18, 2014 Accepted: September 5, 2014 Article in press: September 5, 2014 Published online: February 21, 2015 Processing time: 256 Days and 2 Hours
Core Tip
Core tip: We combined community and hospital services in order to improve patient management, and established an integrated gastroenterology service (IGS). Referral patterns to specialist clinics were optimized; open access route for endoscopic procedures was established; family physicians' knowledge was enhanced; direct communication lines between experts and primary care physicians were opened. Six quality indicators were developed and regularly monitored. Waiting time for procedures decreased significantly, the average cost for patient's visit decreased 7.6%. Six health indicators were improved significantly comparing, 2.5% to 67.5% of the goals. Establishment of an IGS was found to effectively improve quality of care, while being cost-effective.
