A210 THE IMPACT OF IBD REFERRAL QUALITY ON WAIT TIMES
Notice bibliographique
Résumé
Due to health and socioeconomic burdens associated with Inflammatory Bowel Disease (IBD), timely access to specialist care is important. In Canada, speciality gastroenterology (GI) care is accessed only by referral. To receive timely care, referrals must include a high quantity/quality of information. In 2012, 2 in 3 Canadian specialist physicians surveyed reported a lack of basic information on referrals. Referrals are often returned to referring physicians for more information, which is costly to patients and physicians. Some studies have examined referral quality, but not how the quality of referrals influences patient outcomes. The objectives of this study are to determine if referrals to the Nova Scotia Collaborative IBD (NSCIBD) program contain enough information to allow accurate triage for timely access to care, and how the quality of initial referrals to the NSCIBD program inform patient outcomes (e.g. disease flare, hospitalization) while waiting for specialist consultation. This is an ongoing retrospective cohort study of patients referred for appointments in the NSCIBD program between August 2016–2017. A sample size of 200 was required to have a power of 0.80 (p=0.50). Patients were included if they were referred for a first visit to the NSCIBD program for confirmed or suspected IBD. Referrals were excluded if they were for a non-IBD-related concern, an endoscopic test, or a follow up. Referrals were evaluated using a data abstraction form developed with an IBD specialist and two GI nurse practitioners. Based on the information included, referrals were classified as either low, moderate, or high quality. Descriptive statistics were used for a preliminary analysis of the baseline, cross-sectional data. To date, 150 records have been reviewed. There were 9 high quality referrals (6.0%), 32 moderate (21.0%), and 109 low quality referrals (72.7%). The majority of referrals were from family doctors (49.3%) with 81.1% of those being low quality. On average, patients with low quality referrals had a mean wait time of 48.0 days (SD=173.3, range=0–873 days) until triage and a mean wait time of 29.9 weeks (SD=37.3, range=0–160 weeks) to be seen by a GI. Patients with moderate-high quality referrals had a mean wait time of 16.6 days (SD=21.9, range=0–81 days) for triage and a mean of 16.7 weeks (SD=14.9, range=1–65 weeks) to be seen by a GI. The majority of referrals analyzed to date are low quality and have longer average wait times. Prolonged wait time is concerning given its documented impact on patient satisfaction, quality of life and administrative resources. Further analysis will focus on whether there are significant differences in patient outcomes between the qualities of referrals, and factors informing referral quality. Moving forward, higher levels of referrer education, as well as patient awareness and advocacy are needed. CIHRNova Scotia Health Authority Fund
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,032 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».