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P809 Quality of care through the eyes of the patients in a Spanish inflammatory bowel disease Unit

M. J. Casanova*1, M. Chaparro1, C. García-Cotarelo2, J. P. Gisbert1

1Hospital Universitario de La Princesa, IIS-IP , Universidad Autónoma de Madrid and CIBEREHD, Gastroenterology Unit, Madrid, Spain, 2Ekineo Business Intelligence / www.in-pacient.es Barcelona, Spain

Background

The aim of the present study was to evaluate the quality of healthcare from a point of view of the patients in an inflammatory bowel disease (IBD) Unit.

Methods

Observational, prospective, unicentre study. Patients diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC) attending at the IBD Unit of Hospital Universitario de La Princesa, were invited to anonymously fill the ‘quality of care through the eyes of patients with IBD’ (QUOTE-IBD) questionnaire. The same questionnaire was applied to patients from other Spanish IBD Units, as a control group. QUOTE-IBD is a validated 23-items questionnaire on healthcare which explores the Importance that patients give to care aspects, and the Performance of medical practices and healthcare workers. Each item assesses 8 care dimensions: competence, autonomy, courtesy, accessibility, information, costs, continuity of care, and accommodation. The combined effect of Importance and Performance is defined as Quality Impact (QI). The QI of total care was calculated as the average of the QI’s from each dimension, and for every care dimension a QI score ≥9 was considered as patient satisfaction.

Results

100 patients (51% women, median age 49 years, 54% CD) from our IBD Unit and 100 controls completed the QUOTE-IBD. A QI score lower than 9 was reported for all the dimensions of care. In our patients, the QI of total care score was higher than in controls (7.70 ± 0.2 vs. 7.05 ± 0.19, p = 0.007). In terms of dimensions, patients gave the highest Importance score to aspects related to Information (8.24), followed by Competence in IBD care (7.86). In the subanalysis, Competence was more relevant for patients with a disease duration >10 years vs. < 10 years (8.24 vs. 7.57, p = 0.037). Women vs. men (7.23 vs. 7.84, p = 0.045) and patients with surgical interventions vs. non-surgical patients (7.06 vs. 7.70, p = 0.045) gave less importance to Courtesy. Accommodation was more important to UC vs. CD (7.51 vs. 6.64, p = 0.022). The scores of Performance ranged from 0.4 ± 0.29 for Continuity of care to 0.01 ± 0.1 for Cost. In terms of dimensions of healthcare, the scores of QI ranged from 6.78 ± 2.9 for Information to 9.9 ± 1 for Costs. Compared with control group, all dimensions except Accommodation had a higher QI in our patients. Differences in Competence (7.21 ± 0.25 vs. 8.05 ± 0.26 p = 0.027) and Continuity of Care (6.17 ± 0.27 vs. 7.27 ± 0.27) were statistically significant.

Conclusion

According to QUOTE-IBD, the quality of care of our IBD Unit has room for improvement. Patients gave more Importance to Information about IBD and they considered that we had our best Performance in Continuity of care. The QI total care score and the QI in almost all dimensions of care were higher in our Unit than in controls.