The impacts of an inflammatory bowel disease nurse specialist on the quality of care and costs in Finland

Abstract:

Introduction: A specialized inflammatory bowel disease (IBD) nurse is considered a valuable and cost-effective member of a multidisciplinary team, not all clinics responsible for IBD care employ such nurses. We evaluated IBD nurse resources, quality of care and cost effects on IBD patients care in a nationwide study in Finland.

Methods: A healthcare professional electronic survey was conducted in order to assess the impact of an IBD nurse on the quality of care. To study the cost effects, we obtained nationwide comprehensive data covering years between 2008 and 2016 from major administrative healthcare districts of Finland. Patients with a diagnosis of IBD (ICD-code K50 or K51) were identified from the data and their personal contacts and hospitalization were analyzed. The results were compared between healthcare districts with an IBD nurse and healthcare districts without an IBD nurse.

Results: Forty-nine physicians and 88 nurses responded to the survey. Of the physicians, 92% reported that an established IBD nurse had released physician’s resources. The most important IBD nurse contributions listed were patient support and follow-up (79–81% of the respondents).

Healthcare district, which had an established IBD nurse, produced more patient contacts. A larger proportion of the contacts was managed by the IBD nurse. Clinics with an IBD nurse reported less patient hospitalization (4–9% vs 11–19%, p < .001). Estimated annual cost savings while employing an IBD nurse may be significant.

Conclusion: The introduction of an IBD nurse led to better quality of care and potentially significant cost savings by reducing hospitalization rates and reallocating physician’s time resources.

Keywords:

• Crohn’s disease
• IBD nurse
• cost effects
• ulcerative colitis

Acknowledgements

MSD supported the study in practical matters, but the study sponsor played no role in the study design, data analyses and interpretation, conclusions or decision to write and submit this manuscript. The Success Clinic that performed the electronic survey had either no role in data interpretation, conclusions or decision to write and submit this manuscript.

Disclosure statement

PM has received consultancy and lecture fees and travel support from Abbvie, Allergan, AOP Orphan Pharmaceuticals, Ferring, Janssen-Cilag, MSD, Pfizer, Shire, Tillots Pharma, and Takeda. AJ has received lecture fees and travel support from Abbvie, Ferring, Janssen-Cilag, MSD, MEDA, Mylan, Pfizer, Takeda and Tillotts Pharma, and consultancy from Abbvie, Janssen-Cilag, MSD, Pfizer, Takeda and Tillotts Pharma. TT has received lecture fees and travel support from Abbvie, MSD, Pfizer, and Takeda, and consultancy from MSD. K-LK has received financial support from Pediatric Research Foundation and Helsinki University Hospital Research Fund, consultancy and lecture fees form Abbvie, Ferring, MSD and Tillotts Pharma. PaMä and AA are employees of Nordic Health Group. All authors declare no personal conflict of interests.