In:
Journal of Clinical Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 4 ( 2018-04), p. 319-325
Abstract:
Telephone activity is essential in management of complex chronic diseases including inflammatory bowel disease (IBD). Telephone encounters logged in the electronic medical record have recently been proposed as a surrogate marker of disease activity and impending health care utilization; however, the association between telephone calls and financial expenditures has not been evaluated. Study: We performed a 3-year prospective observational study of telephone encounters logged at a tertiary referral IBD center. We analyzed patient demographics, disease characteristics, comorbidities, clinical activity, and health care financial charges by telephone encounter frequency. Results: Eight hundred one patients met inclusion criteria (52.3% female; mean age, 44.1 y), accounted for 12,669 telephone encounters, and accrued $70,513,449 in charges over 3 years. High telephone encounter frequency was associated with female gender ( P =0.003), anxiety/depression ( P 〈 0.001), and prior IBD surgery ( P 〈 0.001). High telephone encounter categories had significantly more hospitalizations ( P 〈 0.001), IBD surgery ( P 〈 0.001), worse quality of life ( P 〈 0.001), more corticosteroid ( P 〈 0.001), biological ( P 〈 0.001), and opiate prescriptions ( P 〈 0.001). High telephone encounter frequency patients amassed higher total available charges in each year ( P 〈 0.001) and over the 3 years ( P 〈 0.001). Telephone encounters in 2009 ( P =0.02) and 2010 ( P 〈 0.001) were significantly associated with financial charges the following year after controlling for demographic, utilization, and medication covariates. Conclusions: Increased telephone encounters are associated with significantly higher health care utilization and financial expenditures. Increased call frequency is predictive of future health care spending. Telephone encounters are a useful tool to identify patients at risk of clinical deterioration and large financial expense.
Type of Medium:
Online Resource
ISSN:
0192-0790
DOI:
10.1097/MCG.0000000000000801
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2018
detail.hit.zdb_id:
2041558-8
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