Effect upon hospital activity of the application of a continued care model centered on patients with inflammatory bowel disease.

BACKGROUND: Since 1999, the Crohn-Colitis Care Unit (UACC) has been dedicated to the integral management of patients with Crohn´s disease (CD) and ulcerative colitis (UC). The working methodology of the UACC is based on personalized, continued, nonphysical presence, open access and patient-centered care. From its creation, the UACC has experienced an increase in the number of its users and outpatient services. However, the impact of the activity of the UACC upon patient hospitalization is not known. OBJECTIVES: To determine the hospital activity related to CD and UC, and correlate it to the activity of the UACC. METHODS: A retrospective evaluation was made of the physical presence and non-presence activities of the UACC from January 1999 to December 2008, and of the hospital admissions and mean durations of stay due to CD and UC during that same time period. RESULTS: The number of attended patients and of presence and non-presence activities of the UACC has gradually increased. This increase contrasts with the number of annual hospital admissions, which has remained stable during the study period, with 200-300 admissions/year. Consequently, the hospitalized patients / UACC registered patients ratio has decreased from 0.36 at the start of the study period to 0.14 at the end. The median hospital stay has also decreased, from 11 days at the start of the study period to 8 days at the end. CONCLUSIONS: The UACC allows effective management of IBD patient care, since it is able to attend the needs of more patients without increasing the number of admissions, and shortening the duration of hospital stay.

Efecto de la aplicación de un modelo de asistencia continuada centrada en el paciente con enfermedad inflamatoria intestinal en la actividad hospitalaria / Effect upon hospital activity of the application of a continued care model centered on patients with inflammatory bowel disease

Introducción: desde 1999 está en funcionamiento la Unidad de Atención Crohn-Colitis (UACC) para la atención integral a los pacientes con enfermedad de Crohn (EC) y colitis ulcerosa (CU). La UACC sigue un método de trabajo basado en la atención personalizada, continuada, no presencial, de acceso abierto y centrada en el paciente. Desde su implantación, la UACC se ha relacionado con un aumento en el número de usuarios y de actividades. Se desconoce, sin embargo, la repercusión que tiene el funcionamiento UACC sobre la hospitalización de los pacientes. Objetivos: determinar la actividad hospitalaria relacionada con la EC y la CU y su relación con la actividad desarrollada en la UACC. Métodos: revisión de la actividad desarrollada en la UACC desde enero de 1999 a diciembre de 2008, y de los ingresos hospitalarios y estancias medias hospitalarias por EC y CU en el mismo período. Resultados: el número de usuarios y de actividades prestadas en la UACC, ha aumentado de forma progresiva. Dicho incremento contrasta con el número anual de ingresos hospitalarios, que ha permanecido estacionario en 200-300 ingresos/año. En consecuencia, la ratio pacientes hospitalizados/pacientes registrados en la UACC ha disminuido de 0,36 a 0,14. La estancia media hospitalaria también se ha reducido, de 11 días a 8 días al final del periodo de observación. Conclusiones: el modelo UACC permite una gestión más eficaz de atención a los pacientes con EII ya que consigue atender las necesidades de más pacientes, sin aumentar el número de ingresos y acortando las estancias hospitalarias(AU)

Background: since 1999, the Crohn-Colitis Care Unit (UACC) has been dedicated to the integral management of patients with Crohn’s disease (CD) and ulcerative colitis (UC). The working methodology of the UACC is based on personalized, continued, nonphysical presence, open access and patient-centered care. From its creation, the UACC has experienced an increase in the number of its users and outpatient services. However, the impact of the activity of the UACC upon patient hospitalization is not known. Objectives: to determine the hospital activity related to CD and UC, and correlate it to the activity of the UACC. Methods: a retrospective evaluation was made of the physical presence and non-presence activities of the UACC from January 1999 to December 2008, and of the hospital admissions and mean durations of stay due to CD and UC during that same time period. Results: the number of attended patients and of presence and non-presence activities of the UACC has gradually increased. This increase contrasts with the number of annual hospital admissions, which has remained stable during the study period, with 200-300 admissions/year. Consequently, the hospitalized patients / UACC registered patients ratio has decreased from 0.36 at the start of the study period to 0.14 at the end. The median hospital stay has also decreased, from 11 days at the start of the study period to 8 days at the end. Conclusions: the UACC allows effective management of IBD patient care, since it is able to attend the needs of more patients without increasing the number of admissions, and shortening the duration of hospital stay(AU)

[Application of a model of continued attention in inflammatory bowel disease: the Crohn-colitis care unit]. / Aplicación de un modelo de asistencia continuada en la enfermedad inflamatoria intestinal: la Unidad de Atención Crohn-Colitis.

OBJECTIVE: To describe the activity performed in the Crohn-Colitis Care Unit (CCCU) and its web portal (http://www.ua-cc.org) during the first 9 years (1999-2007). MATERIAL AND METHODS: We retrospectively reviewed the presential and non-presential activity carried out in the CCCU from January 1999 to June 2007 by analyzing the data available in the data base and in the CCCU web portal from January 2002 (data available from the private web environment). RESULTS: The number of patients has progressively increased, and currently stands at 1784. There is equal distribution by gender (880 men vs 904 women) and diagnosis (849 Crohn's disease vs 893 ulcerative colitis). Patients are mostly younger than 50 years old (1404 patients). The non-presential resources (telephone and fax) have been used to a greater extent than the presential resources (11,173 vs 5164). Most requests (15,198) have been specific consultations relating to the disease. The CCCU also monitors treatments such as corticosteroids, immunomodulators, biological agents and granulocyte apheresis (663 in the last year). The web portal has received more than 150,000 visits and has 3698 registered users (1552 patients, 1374 health professionals, 384 relatives of patients, and 388 institutions), mostly from Spain and Latin America (2087 and 1555 respectively). CONCLUSIONS: The CCCU offers continued, participative and dynamic care, which promotes remote healthcare and optimizes the care of patients with inflammatory bowel disease.

Aplicación de un modelo de asistencia continuada en la enfermedad inflamatoria intestinal: la Unidad de Atención Crohn-Colitis / Application of a model of continued attention in inflammatory bowel disease: the Crohn-colitis care unit

Objetivos: describir la actividad desarrollada en la Unidad de Atención Crohn-Colitis (UACC) en sus 9 años de funcionamiento y su línea virtual (http://www.ua-cc.org).Material y métodos: revisión retrospectiva de la actividad presencial y a distancia desempeñada en la UACC desde enero de 1999 a junio de 2007 (mediante el análisis de los datos disponibles en la base de datos), y del portal web de la UACC desde enero de 2002 (datos disponibles en el entorno web de uso privado).Resultados: el número de pacientes ha ido aumentando de forma progresiva, y actualmente es de 1.784. Hay una distribución igual por género (880 varones y 904 mujeres) y diagnóstico (849 con enfermedad de Crohn y 893 con colitis ulcerosa). La población atendida esencialmente es menor de 50 años (1.404 pacientes). La atención a distancia (telefónica y fax) ha sido la prioritaria, se han atendido 11.173 demandas y de forma presencial 5.164. La mayoría de las demandas (15.198) han sido consultas específicas sobre la enfermedad. Desde la UACC, también se registran los tratamientos corticoideos, inmunomoduladores, agentes biológicos y granulocitoaféresis (663 en el último año). El portal web ha recibido más de 150.000 visitas y cuenta con 3.698 usuarios registrados (1.552 pacientes, 1.374 profesionales de la salud, 384 familiares de pacientes y 388 de otras instituciones), la mayoría españoles y de países sudamericanos (2.087 y 1.555, respectivamente).Conclusiones: la UACC presta una atención continuada, participativa y dinámica, que promociona el control a distancia y optimiza la atención sanitaria de los pacientes con enfermedad inflamatoria intestinal(AU)

Objective: To describe the activity performed in the Crohn-Colitis Care Unit (CCCU) and its web portal (http://www.ua-cc.org) during the first 9 years (1999–2007).Material and methods: We retrospectively reviewed the presential and non-presential activity carried out in the CCCU from January 1999 to June 2007 by analyzing the data available in the data base and in the CCCU web portal from January 2002 (data available from the private web environment).Results: The number of patients has progressively increased, and currently stands at 1784. There is equal distribution by gender (880 men vs 904 women) and diagnosis (849 Crohn's disease vs 893 ulcerative colitis). Patients are mostly younger than 50 years old (1404 patients). The non-presential resources (telephone and fax) have been used to a greater extent than the presential resources (11,173 vs 5164). Most requests (15,198) have been specific consultations relating to the disease. The CCCU also monitors treatments such as corticosteroids, immunomodulators, biological agents and granulocyte apheresis (663 in the last year). The web portal has received more than 150,000 visits and has 3698 registered users (1552 patients, 1374 health professionals, 384 relatives of patients, and 388 institutions), mostly from Spain and Latin America (2087 and 1555 respectively).Conclusions: The CCCU offers continued, participative and dynamic care, which promotes remote healthcare and optimizes the care of patients with inflammatory bowel disease(AU)