title: Documented compliance with inflammatory bowel disease quality measures is poor.
abstract: OBJECTIVE
  Quality metrics allows health care to be standardized and monitored. The American Gastroenterological Association (AGA) established quality metrics for inflammatory bowel disease (IBD) in 2011, but compliance is unknown.
  
  
  METHODS
  Patients with IBD seen in the gastroenterology clinics at a tertiary care medical center during April 2013 were included. Charts were reviewed for the current state of compliance with the publicized AGA measures over the prior 12 months. Records were assessed for type of IBD, year of diagnosis, number of medications, comorbidities, hospitalizations and gastroenterology clinic visits in the last year, presence of primary care physician (PCP) at the institution, and involvement of a specialist in IBD or a trainee. Univariate and multivariate logistic regression analyses were done using SPSS.
  
  
  RESULTS
  Only 6.5 % (24/367) of patients had all applicable core measures documented. In univariate analysis, year of IBD diagnosis (p = 0.014), number of comorbidities (p = 0.024), seen by a specialist in IBD (p = 0.002), seen by a gastroenterology fellow or resident (p = 0.034), and having a PCP at the institution (p = 0.006) were significant. In multivariate analysis, seen by a specialist in IBD (5.36, 95 % CI 1.22-23.63, p = 0.027), having a PCP at the institution (3.24, 95 % CI 1.23-8.54, p = 0.018), and year of IBD diagnosis (0.967, 95 % CI 0.937-0.999, p = 0.042) remained significant. Screening for tobacco abuse was the most frequently assessed (96 %, n = 352/367) core measure, while pneumococcal immunization (21 %, n = 76/367) was the least.
  
  
  CONCLUSIONS
  Our study demonstrates poor compliance with IBD quality metrics. Additional studies are needed to determine the causes of failure to comply with the quality metrics.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave E/DANA 501, Boston, MA, 02215, USA, jfeuerst@bidmc.harvard.edu.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Feuerstein
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Lewandowski
authors.forename: Manuel
authors.initials: M
authors.lastname: Martinez-Vazquez
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Leffler
authors.forename: Adam S
authors.initials: AS
authors.lastname: Cheifetz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004282:Documentation / Q000592:standards*; D005260:Female; D005762:Gastroenterology / Q000592:standards*; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008499:Medical Records / Q000592:standards*; D008875:Middle Aged; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011237:Predictive Value of Tests; D019984:Quality Indicators, Health Care / Q000592:standards*; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000592:standards; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult