Establishing an integrated gastroenterology service between a medical center and the community

Table 1 Quality indicators developed for assessing the integrated gastroenterology service

Indicator	Denominator	Numerator
Bone densitometry for patients with IBD (6-11)	Patients > 20 yr old with Crohn’s disease or ulcerative colitis	Of those in the denominator, patients who underwent bone densitometry
Preventive medications for high risk patients on aspirin/NSAIDs (12-15)	High-risk patients (> 70 yr old, underlying comorbidity1 or concomitant medications2) on chronic aspirin/NSAIDs therapy	Of those in the denominator, patients who were purchased proton pump inhibitors
Colonoscopy following positive FOBT (16-18)	Patients with positive FOBT	Of those in the denominator, patients who underwent colonoscopy within 6 mo
EGD in Barrett's esophagus (19-22)	Patients with a diagnosis of Barret's esophagus	Of those in the denominator, patients who underwent EGD within the last 3 yr
Documentation of family history of CRC (positive or negative) (23-27)	Documentation of family history of CRC	Patients with a positive family history of CRC
Colonoscopy in-patients with a family history of CRC (28-30)	Patients who underwent colonoscopy	Of those in the denominator, patients who had a family history of CRC

¹Peptic disease, ischemic heart disease, chronic renal failure, liver cirrhosis, rheumatoid arthritis;

²Corticosteroids, anticoagulants, other anti-platelet drugs (clopidogrel, ticlopidine). IBD: Inflammatory bowel disease; NSAIDS: Non-steroidal anti-inflammatory drugs; FOBT: Fecal occult blood test; EGD: Esophago-gastro-duodenoscopy; CRC: Colorectal cancer.