The symptoms of Inflammatory Bowel Disease (IBD) often cause significant patient distress and require urgent medical attention. Unfortunately, many patients have limited access to healthcare providers. Physician clinic schedules tend to fill up months in advance, limiting facetime with providers. To maintain patient satisfaction and provide high quality healthcare, it is essential to provider care outside the traditional office setting. Technology has begun to play a role in facilitating patient-doctor communication. We hypothesize that IBD patients are more likely to use alternative forms of communication with providers. This study seeks to evaluate the differences in utilization of electronic physician-patient communication in IBD patients as compared to non-IBD gastroenterology patients.Methods:
A retrospective chart review of IBD patients seen at an urban university medical center over a 6-month period was conducted to evaluate the associations between patient-physician communication, IBD diagnosis (Crohn's Disease versus Ulcerative Colitis), and disease severity. A control group was identified and included patients seen at the GI clinic for chronic diagnoses other than IBD, such as GERD and IBS. All included patients were under the care of faculty gastroenterologists. Controls were matched by age, gender, and treating gastroenterologist at a ratio of 1:1 to 1:2. A Microsoft Excel database maintaining subject confidentiality was created. Statistical analysis was conducted using a 2-tailed Fisher's Exact Test with a significance set at P < 0.05.Results:
A total of 275 IBD patients and 127 patients from the control group were included in the analysis. The mean ages of patients in the IBD and control group populations were 42.9 and 46.8 years, respectively. There were 1166 total patient encounters, comprised of office visits and non-office visits, including ER visits and phone or email communications. There were 429 office visits and 402 non-office visits in the IBD group, as compared to 262 office visits and 73 non-office visits in the control group. Patients in the IBD group had less office visits per patient compared to the control group (P = 0.036), at a ratio of 0.75:1. However, patients in the IBD group had significantly more non-office visits per patient than the control group (P = 0.0001), at a ratio of 2.5:1. Similarly, there was a statistically significant increase in the proportion of non-office visit to total visits among the IBD group (P = 0.0001).Conclusions:
Healthcare accessibility is an important issue in all medical practices and has great impact on patient satisfaction and the management of chronic disease. Our data indicate a significant difference in non-office visit communication between IBD patients and the control group. The increased utilization of non-office visits by IBD patients highlights the need to focus on faster, easier patient-physician communication modalities as these patients have a more frequent need for urgent care, especially during times of active disease.