Quality of health care in inflammatory bowel disease and its assessment

Abstract

SUMMARY
Patients with inflammatory bowel disease (IBD) are consistently
high users of health care services. They need continuous
medication, frequent follow up visits, while their
life expectancy is normal. One major parameter, which
creeps into the assessment of quality of care, is organization
of health care system. However, relatively little research
exists on the characteristics and the organization of an ideal
health care system which will effectively satisfy the needs
of the chronically ill patient. Regarding money spent on
chronic illnesses in terms of societal costs, IBD is less costly
than, for example, coronary diseases, since loss of work
hours, disability, or early death are less common. In terms
of pure economic costs, IBD patients can be more costly
than other chronic patients depending on age of disease
onset and severity of illness. Crohns disease patients consider
cost aspects as an important element of quality more
than ulcerative colitis patients do. Standard framework for
the assessment of quality of care remains Donabedians
approach according to the Structure-Process-Outcome characterization.
Lack of information is associated with more
disease related worries and concerns of patients and, accordingly,
with decreased quality of life. Finally, the patient
s perception about high quality health care and his/
her satisfaction as a consumer of health care services
are extremely important issues for assessing quality of
health care. Key words: Inflammatory bowel disease, Ulcerative colitis,
Crohns disease, care, quality of care, health services, health
system, patients satisfaction