A chronic care model significantly decreases costs and healthcare utilisation in patients with inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic condition, yet the model of care is often reactive. We sought to examine whether a formal IBD service (IBDS) reduced inpatient healthcare utilisation or lowered costs for inpatient care. With protocols, routine nurse phone follow-up a help-line, more proactive care was delivered, with many symptoms and concerns dealt with prior to routine presentation. Over two five month periods before (2007/8) and after (2009/10) introducing a formal IBDS two discrete cohorts of admitted IBD patients were identified at a single centre. Each patient was assigned five contemporaneously admitted, age and gender matched controls. Inpatient healthcare utilisation was compared between patients and controls and disease-specific factors amongst the two IBD cohorts. The initial audit captured 102 admitted IBD patients (510 controls, median age 44years, 57% female); the second audit 95 patients (475 controls, median age 46years, 45.3% female). In 2009/10, the number of admissions was lower in IBD patients than in controls (mean 1.53+/−1.03 vs. 2.54+/−2.35; p