Can coordinated care help patients with high-risk IBD?

A team looks at how a more intentional approach to care can benefit individuals with the gastroenterological condition.

5:00 AM

Author | Jina Sawani

woman holding stomach pain mustard colored shirt jeans sitting on couch
Getty Images

Inflammatory bowel disease, or IBD, affects nearly 3.1 million Americans. The condition includes Crohn's disease and ulcerative colitis and can be quite costly for its patients.

"Not only are the symptoms associated with IBD significant, the clinical outcomes linked to the treatment of this disease are, as well," said Jeffrey Berinstein, M.D., a gastroenterologist and clinical instructor at Michigan Medicine. "There is a lot of variation in how patients respond to specific forms of care, as well as high direct costs associated with the disease. IBD can be a very challenging condition to live with."

These factors inspired Berinstein and a team of fellow experts to examine if a more coordinated approach to health care could eventually alleviate the cost and symptom burdens associated with IBD. Their research was recently published in Clinical Gastroenterology and Hepatology.

"Our research really honed in on whether or not a strategy focused on improved care coordination, or the intentional delivery of patient care from interconnected providers, improved the burden of symptoms for patients with IBD and reduced their overall health care costs," said Berinstein. "And in order to do this, our study participants were patients with the condition in the top quintile of predicted health care utilization and costs." 

The team then used a randomized trial to assess how effective a patient-specific – yet multifaceted – care coordination plan for individuals with IBD was in lessening symptoms and cost. 

"We looked at patients with IBD that were randomized to 'usual care' or our care coordination 'intervention' over a nine-month period, from April of 2019 to January of 2020," said Berinstein. "Our care coordination intervention e was comprised of proactive symptom monitoring and specific care coordination triggered algorithms."

Berinstein notes that these electronic health record embedded questionnaires generated automated scores for each patient. The team would then use this patient-tailored information to tweak their care even further in hopes of meeting their personalized needs.

"If a patient was continuously having difficulty paying for their medications, for example, then we'd coordinate their care in such a way that they would speak with a social worker for help," said Berinstein. "And if someone was reporting high levels of anxiety and depression related to their condition, we'd recommend that they meet with a GI behavioral health specialist."

By taking these diverse 'scores' into consideration, Berinstein and his team were able to thoughtfully design care plans that benefited these high-risk IBD patients.

"We found that we were able to improve patient-reported symptom scores significantly yet found this low-cost and scalable approach didn't increase the overall cost for patient outcomes."

As Berinstein looks ahead, he hopes that this research will help inform a better and more cost-effective approach to caring for high-risk patients with IBD.

"Through our work we've been able to show that care coordination programs are an effective way to improve symptom scores without directly increasing the costs for individuals with this oftentimes debilitating condition."

Paper cited: "A Care Coordination Intervention Improves Symptoms But Not Charges in High-Risk Patients With Inflammatory Bowel Disease," Clinical Gastroenterology and Hepatology. DOI: 10.1016/j.cgh.2021.08.034

Like Podcasts? Add the Michigan Medicine News Break on Apple Podcasts, Spotify or anywhere you listen to podcasts.

More Articles About: Lab Report Inflammatory Bowel Disease (IBD) All Research Topics Health Care Delivery, Policy and Economics Health Care Quality Hospitals & Centers Crohn's and Colitis Digestive (GI) Conditions
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]


Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Featured News & Stories cells colorful
Health Lab
Improvements in human genome databases offer a promising future for cancer research
A gene sequencing method called ribosome profiling has expanded our understanding of the human genome by identifying previously unknown protein coding regions. Also known as Ribo-seq, this method allows researchers to get a high-resolution snapshot of protein production in cells.
boy sketching comics
Health Lab
Combating Crohn’s with comics
A teenage patient’s unique way of detailing his experience with Crohn’s disease.
stethoscope in gun outline
Health Lab
Many primary care providers and patients wary of discussing firearms
Screening primary care patients for gun ownership has been recommended especially for people with mental health issues. A Michigan Medicinestudy shows wariness by providers and patients.
flies moving sled in snow with person
Health Lab
Gene links exercise endurance, cold tolerance and cellular maintenance in flies
A study in PNAS identifies a protein that, when missing, makes exercising in the cold that much harder—that is, at least in fruit flies.
bacteria black background yellow cell
Health Lab
The surprising origin of a deadly hospital infection
Surprising findings from a Michigan Medicine study in Nature Medicine suggest that the burden of C. diff infection may be less a matter of hospital transmission and more a result of characteristics associated with the patients themselves.
Health Lab
Genetic mutation linked to adrenal tumor and hypertension
Research from the Department of Molecular & Integrative Physiology at Michigan Medicine identifies a previously unknown genetic mutation that causes the disease called primary aldosteronism in certain populations.