Efecto de la aplicación de un modelo de asistencia continuada centrada en el paciente con enfermedad inflamatoria intestinal en la actividad hospitalaria

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.