Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 18 January 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Intercenter variation in the initial management of children with Crohn's disease

July's issue of Inflammatory Bowel Diseases determines the extent of intercenter variation in the initial management of children newly-diagnosed with Crohn's disease

News image

fiogf49gjkf04

Variation in care is an ubiquitous feature of medical practice and may lead to significant differences in health care costs, quality, and outcomes.

Dr Michael D. Kappelman and colleagues from the USA and Canada undertook this study to determine the extent of intercenter variation in the initial management of children newly diagnosed with Crohn's disease.

They analyzed the utilization of 5 classes of medication (immunomodulators, prednisone, antibiotics, 5-aminosalicylates, and infliximab) among 311 children with newly diagnosed Crohn's disease followed at 10 North American pediatric gastroenterology centers.

Widespread intercenter variation was observed.
Inflammatory Bowel Diseases

Multivariate logistic regression was used to compare the utilization rate of each class of medication at each of the 10 centers, adjusting for potential confounders including patient age, sex, race, disease severity, and anatomic location of disease.

Median utilization of each class of medication was: immunomodulators, 56% (range 29%-97%); prednisone, 78% (range 32%-88%); antibiotics, 29% (range 11%-68%); 5-aminosalicylates, 63.5% (range 18%-92%); and infliximab, 7.5% (range 3%-21%).

Each of these treatments showed statistically significant intercenter variation in utilization (P < 0.001 for immunomodulators, prednisone, antibiotics, and 5-ASA; P = 0.02 for infliximab).

After adjusting for the demographic and clinical factors listed above, intercenter variation remained significant; however, the low utilization of infliximab precluded multivariate analysis.

Dr Kappelman concluded that, "Widespread intercenter variation in the medical management of newly diagnosed children with Crohn's disease was observed, even after adjusting for possible differences in case mix between institutions".

He thought that, "This variation may lead to unintended differences in health care costs and outcomes".

Inflammatory Bowel Diseases 2007; 13 (7), 890 - 895
08 June 2007

Go to top of page Email this page Email this page to a colleague

 18 January 2018 
Sleeve gastrectomy vs Roux-en-Y gastric bypass
 18 January 2018 
Healthcare costs of liver cancer in the USA
 18 January 2018 
High-risk adenomas at colonoscopy
 17 January 2018 
“Weekend effect” in upper GI hemorrhage
 17 January 2018 
Gut dysbiosis and non-antibiotic prescription medications
 17 January 2018 
Reducing surgical infections in high-outlier colorectal unit
 16 January 2018 
Bundle of care in GI cancer surgery
 16 January 2018 
Anxiety about colonoscopy
 16 January 2018 
Thiopurines and colorectal neoplasia in IBD
 15 January 2018 
Risks of death after liver transplants for liver cancer
 15 January 2018 
Recent advances in hepatocellular carcinoma
 15 January 2018 
Ileostomy output using telemedicine
 12 January 2018 
Surveillance protocols after colorectal cancer resection
 12 January 2018 
Biologic therapy by pregnant women with IBD and infant vaccines
 12 January 2018 
Biologic therapies for IBD in the USA
 11 January 2018 
Genetic risk factors in GERD
 11 January 2018 
Predictor of colorectal adenoma
 11 January 2018 
Ectopic pregnancy in IBD 
 10 January 2018 
Fecal immunochemical tests for colorectal cancer screening
 10 January 2018 
Risk factors for advanced NAFLD
 10 January 2018 
Dyspepsia prevalence with gastroesophageal reflux–type symptoms
 09 January 2018 
Screening intervals for people with family histories of colorectal cancer
 09 January 2018 
Financial impact of colorectal cancer
 09 January 2018 
Current practice and future research in autoimmune hepatitis
 08 January 2018 
Improving prognosis in patients with primary sclerosing cholangitis
 08 January 2018 
Reliability of the IBD index
 08 January 2018 
Aprepitant and nausea with gastroparesis
 05 January 2018 
Autoimmune pancreatitis and IBD
 05 January 2018 
Primary nonresponse to infliximab therapy
 05 January 2018 
Anesthesia assistance in outpatient colonoscopy
 04 January 2018 
Dietary polyphenols in the etiology of IBD
 04 January 2018 
Yoga vs low-FODMAP in IBS
 04 January 2018 
Local esophageal food allergen injections in eosinophilic esophagitis
 03 January 2018 
Population health management for IBD
 03 January 2018 
GERD in asthma and COPD
 03 January 2018 
Critical research gaps in colorectal cancer
 22 December 2017 
Costs of extrahepatic manifestations of Hep C
 22 December 2017 
Cholera vaccine and risk of death in colorectal cancer
 22 December 2017 
Colonoscopy after colorectal cancer resection
 21 December 2017 
Human oral microbiome and pancreatic cancer risk
 21 December 2017 
Health management for IBD
 21 December 2017 
PPI and Alzheimer's disease
 20 December 2017 
Management of abnormal liver blood tests
 20 December 2017 
Incidence of biopsy-verified celiac disease
 20 December 2017 
Osteoporotic fractures in Barrett's esophagus
 19 December 2017 
Alcohol abstinence and alcoholic hepatitis
 19 December 2017 
Family burden of pediatric Crohn's in the USA
 19 December 2017 
Early readmission in IBD patients
 18 December 2017 
Colorectal cancer mortality with low-risk adenomas at colonoscopy
 18 December 2017 
Disease activity indices in celiac disease
 18 December 2017 
Smoking behaviour predicted the risk of surgery in Crohn's
 15 December 2017 
Molecular classification of Crohn's disease
 15 December 2017 
Medical cannabinoid legalization policy and vomiting
 15 December 2017 
Inflammatory diet pattern and colorectal cancer risk
 14 December 2017 
PPIs and gastric cancer after H.pylori eradication
 14 December 2017 
H. pylori eradication therapies in countries with clarithromycin resistance
 13 December 2017 
Disease severity in NAFLD
 13 December 2017 
Tryptophan metabolism and IBD activity
 12 December 2017 
Risk factors in undiagnosed cirrhosis
 12 December 2017 
Monitored anesthesia care for outpatient GI endoscopy

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us