EVALUATING THE IMPACT OF THE SASKATCHEWAN INTEGRATED CARE FOR INFLAMMATORY BOWEL DISEASE ON DIRECT HEALTHCARE COSTS AND QUALITY OF LIFE
Notice bibliographique
Résumé
Integrated models of care (IMC) for inflammatory bowel disease (IBD) are an emerging approach to disease management that aim to provide a holistic patient-centered care while fostering collaboration among various health professionals. Evidence shows that IMC for other chronic conditions can improve health outcomes, increase patients’ satisfaction with care, and reduce costs of care. However, to this day no research has assessed the impact of IMC for IBD on direct healthcare costs. Similarly, the impact of IMC for IBD on health-related quality of life (HRQoL) has not been previously studied, and comparative assessments of the responsiveness of generic and IBD-specific HRQoL for IBD are non-existent. This study aimed to assess the impact of exposure to an IMC for IBD on direct healthcare costs and to perform a comparative evaluation of HRQoL questionnaires. I used administrative health data from Saskatchewan, Canada, to conduct a quasi-experimental population-based study. I included individuals 18 years and older meeting a validated administrative IBD case definition. IBD cases were classified as exposed or non‐exposed to the Saskatchewan IMC. Difference in difference (DID) estimators were calculated to assess the impact of exposure to IMC on direct health care costs for IBD. We found that exposure to an IMC for IBD was associated with significantly higher overall direct healthcare costs, largely driven by the costs of biologic medications. Individuals exposed to the IMC cost the system an average $1,706.5 (95% CI 468 to 3102) more than the non-exposed. A second study using longitudinal data of a cohort of patients recently diagnosed with IBD performed a characterization of HRQoL questionnaires, as well as a comparative evaluation of their responsiveness. Individuals aged 18 years and older recently diagnosed with IBD and seen at an IMC for IBD in Saskatoon, Canada, were enrolled in the cohort. Study participants had a baseline evaluation and follow-up visits that included the assessment of HRQoL through self-administered questionnaires. I observed a trend characterized by scores denoting a better HRQoL across all the questionnaires after one and two years of follow-up. Additionally, the inflammatory bowel disease questionnaire (IBDQ) was found to be in general more responsive at both the dimension specific and the overall scores than the generic questionnaires (i.e., EuroQol iv 5-dimension and the Short Form 36-item [SF-36]). The overall SF-36 score performed comparatively to the IBDQ. This study underscores the need for subsequent economic evaluations, e.g., Cost-Utility Analysis (CUA), to ascertain whether IMC for IBD is likely to result in potential long-term net cost savings. The results of this study indicate that the SF-36 might be the preferred generic HRQoL questionnaire used for calculating quality-adjusted life years in future CUA. Moreover, multicentre studies assessing the impact of IMC on HRQoL are needed.
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 | 0,008 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 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 ».