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Original research
Evaluation of emergency hospital admissions for inflammatory bowel disease as a possible marker of quality of care of British IBD inflammatory bowel disease units
  1. Christian Selinger1,2,
  2. Alex Bottle3,
  3. Christopher A Lamb4,5,
  4. Rachel Ainley6,
  5. Ruth Wakeman6,
  6. Barney Hawthorne7
  1. 1 Leeds Teaching Hospitals, Leeds, UK
  2. 2 University of Leeds, Leeds, UK
  3. 3 Faculty of Medicine, School of Public Health, Imperial College London, London, UK
  4. 4 Newcastle University, Newcastle Upon Tyne, Tyne and Wear, UK
  5. 5 Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, Northumberland, UK
  6. 6 Crohns and Colitis UK, Hatfield, UK
  7. 7 Department of Gastroenterology, Cardiff and Vale UHB, Cardiff, UK
  1. Correspondence to Dr Christian Selinger, Leeds Teaching Hospitals, Leeds, UK; christian.selinger{at}web.de

Abstract

Background Key performance indicators (KPIs) are required to facilitate quality improvement for inflammatory bowel disease (IBD). Emergency admissions for IBD may represent a possible KPI.

Methods IBD emergency admissions for 2018–2019 from Hospital Episodes Statistics for England were compared per population and per IBD cases with patient-reported quality of care from the IBD Patient Survey 2019. Patient-reported accident and emergency (A&E) attendances and hospital admissions for IBD were also compared with patient-reported quality of care.

Results For 124 IBD services within England we found only a weak and not statistically significant correlation between IBD admissions per 100 000 population and patient-rated quality of care (Spearman’s rho=0.171; p=0.057). Similarly, there was no significant correlation between IBD admissions per case and patient-rated quality of care (Spearman’s rho=0.164; p=0.113). Patients with ≥2 A&E attendances (OR: 0.72, 95% CI: 0.57 to 0.91; p<0.001) were less likely to report quality of IBD care as good or very good compared with those without A&E attendances. Patients with ≥2 admissions were less likely to rate their care as good or very good (OR: 0.75, 95% CI: 0.65 to 0.88; p<0.0001) compared with those without hospital admissions.

Conclusions There is a clear association for individual patients with ≥2 admissions or A&E attendances with a lower perceived quality of care. In contrast we found no correlation on a per-unit basis for IBD admissions derived from Hospital Episode Statistics with patient-assessed quality of care. Further work is required to determine whether hospital admissions could be a useful KPI for IBD.

  • inflammatory bowel disease

Data availability statement

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Data availability statement

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Footnotes

  • Contributors CS designed the study and performed the analysis. All authors interpreted the results. CS wrote the draft manuscript. All authors critically reviewed the draft manuscript and approved the final manuscript. CS is the guarantor of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests CS has received unrestricted research grants from Warner Chilcott, Janssen, Celltrion and AbbVie, has provided consultancy to Warner Chilcott, Dr Falk, AbbVie, Takeda, Fresenius Kabi, Galapagos, Ferring, RedX, Arena and Janssen, and had speaker arrangements with Warner Chilcott, Dr Falk, AbbVie, MSD, Pfizer, Bristol Myers Squibb, Celltrion and Takeda. AB’s Unit has received grants from Dr Foster (a wholly owned subsidiary of Telstra Health) and Medtronic. AB has provided consultancy to Ireland’s HSE, AZ and Lilly.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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