title: Comparing guideline-based care quality for inflammatory bowel disease and rheumatoid arthritis patients within a medical home.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) patient populations face similar risks of chronic immunosuppression including corticosteroid use. We compared the receipt of preventive services between IBD and RA populations according to published quality metrics.
  
  
  METHODS
  We defined a single-center cohort of patients with IBD or RA receiving specialty and primary care. Electronic health record abstraction assessed quality metrics, sociodemographics, comorbidity, and utilization. Comparisons used multivariate odds ratios and Student's t-tests.
  
  
  RESULTS
  218 RA and 190 IBD patients were included. In multivariate analysis, IBD patients were less likely to receive pneumococcal vaccination (OR=0.29, 95% CI: 0.11-0.85), while RA patients underwent glucocorticoid-induced osteoporosis screening more often (100% vs. 82.5%, p = 0.023).
  
  
  CONCLUSIONS
  Gastroenterologists can improve care quality for IBD patients by assuming greater responsibility for preventive care in IBD patients and/or collaborating with primary care and health systems to improve preventive care delivery.
authors.affiliation: a Department of Medicine, Division of Gastroenterology and Hepatology , University of Wisconsin , Madison , WI , USA.
authors.forename: Freddy
authors.initials: F
authors.lastname: Caldera
authors.affiliation: a Department of Medicine, Division of Gastroenterology and Hepatology , University of Wisconsin , Madison , WI , USA.
authors.forename: Sumona
authors.initials: S
authors.lastname: Saha
authors.affiliation: a Department of Medicine, Division of Gastroenterology and Hepatology , University of Wisconsin , Madison , WI , USA.
authors.forename: Arnold
authors.initials: A
authors.lastname: Wald
authors.affiliation: b Department of Medicine, Division of Internal Medicine , University of Wisconsin , Madison , WI , USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Cooley
authors.affiliation: c Department of Biostatistics and Medical Informatics , University of Wisconsin , Madison , WI , USA.
authors.forename: Ying-Qi
authors.initials: YQ
authors.lastname: Zhao
authors.affiliation: c Department of Biostatistics and Medical Informatics , University of Wisconsin , Madison , WI , USA.
authors.forename: Zhanhai
authors.initials: Z
authors.lastname: Li
authors.affiliation: d Department of Medicine, Rheumatology Division , University of Wisconsin , Madison , WI , USA.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Bartels
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D016009:Chi-Square Distribution; D015897:Comorbidity; D019033:Delivery of Health Care, Integrated / Q000592:standards; D057286:Electronic Health Records; D005260:Female; D000072102:Gastroenterologists / Q000592:standards; D005938:Glucocorticoids / Q000009:adverse effects; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D009894:Opportunistic Infections / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control; D010024:Osteoporosis / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control; D018802:Patient-Centered Care / Q000592:standards*; D010819:Physician's Role; D022242:Pneumococcal Vaccines / Q000627:therapeutic use; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011314:Preventive Health Services / Q000592:standards*; D011320:Primary Health Care / Q000592:standards; D017064:Process Assessment, Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014922:Wisconsin; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D022242:Pneumococcal Vaccines
keywords: Inflammatory bowel disease; preventive care; quality care; rheumatoid arthritis; vaccination