November 12, 2014
Notes: Machado, Marcel Cerqueira Cesar
Fonseca, Gilton Marques
Case Rep Med. 2013;2013:903546. doi: 10.1155/2013/903546. Epub 2013 Aug 29.
Author Address: Department of Clinical Emergencies, LIM 51, University of Sao Paulo School of Medicine, Rua Peixoto Gomide, 515 Conjunto 134, 01409-001 Bela Vista, SP, Brazil.
Reference Type: Journal Article
Record Number: 4984Author: Madan, A., Borckardt, J. J., Barth, K. S., Romagnuolo, J., Morgan, K. A. and Adams, D. B.
Title: Interprofessional collaborative care reduces excess service utilization among individuals with chronic pancreatitis
Journal: J Healthc Qual
Short Title: Interprofessional collaborative care reduces excess service utilization among individuals with chronic pancreatitis
Alternate Journal: Journal for healthcare quality : official publication of the National Association for Healthcare Quality
ISSN: 1945-1474 (Electronic)
Accession Number: 24004038
Keywords: Academic Medical Centers
Length of Stay/trends
Pain Management/*statistics & numerical data
Abstract: BACKGROUND: Pain is common and multifactorial among patients with chronic pancreatitis. Underrecognized and undertreated psychosocial comorbidity can exacerbate pain experience. Excess inpatient service utilization within this patient population prompted a performance improvement initiative at a large academic medical center. METHODS: An interprofessional treatment approach with programmatic medical, surgical, and psychological and psychiatric interventions was rolled-out in January 2007 and length of stay (LOS) was measured on a quarterly basis for a 2-year period. Trends in resource utilization (LOS, estimated opportunity costs) were assessed with a novel modified bootstrapping technique, Simulation Modeling Analysis (SMA). RESULTS: From January 1, 2007, through December 31, 2008, SMA revealed a linear downward trend in LOS (rho = -0.857, p = .0170), and the interprofessional treatment approach was associated with estimated opportunity cost savings of $670,750.27. There were no associated changes in 7-, 14-, and 30-day readmission rates, p > .05. CONCLUSION: Interprofessional care that combines behavioral approaches to pain management; behavioral contingency management for opioid medication management; psychological and psychotropic treatments for depression, anxiety, and addiction in addition to standard medical and surgical treatments for pancreatitis appears to be associated with lower healthcare costs. Future research should examine patient reported outcomes of this model.