Quality of care in inflammatory bowel disease: a review and discussion.
The Institute of Medicine's publications To Err Is Human and Crossing the Quality Chasm publicized the widespread deficits in U.S. health care quality. Emerging studies continue to reveal deficits in the quality of adult and pediatric care, including subspecialty care. The inflammatory bowel diseases (IBD) Crohn's disease and ulcerative colitis require diligent, long-term management and attention to their impact on intestinal and extraintestinal organ systems. Although the quality of IBD care has not been prospectively or comprehensively evaluated in the United States, several small studies have demonstrated significant variation in care. As variation may indicate underuse, overuse, or misuse of medical services, such variation suggests a clear need for translating evidence-based practices into the actual practice and follow-up provided for patients. This article reviews the history, rationale, and methods of quality measurement and improvement and identifies the unique challenges in adapting these general strategies to the care of the inflammatory bowel diseases.
Kappelman
Michael D
MD
Division of Pediatric Gastroenterology, Department of Pediatrics, University of North Carolina Chapel Hill, Chapel Hill, North Carolina 27599, USA. michael_kappelman@med.unc.edu
Palmer
Lena
L
Boyle
Brendan M
BM
Rubin
David T
DT
D000328:Adult; D002648:Child; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D011787:Quality of Health Care