Pediatric constipation results in 2.5 million health care provider visits every year. Nearly 625,000 of these visits are funneled to pediatric gastroenterology specialists, costing, by some estimates, nearly $3.9 billion per year in the United States.
According to members of Boston Children’s Hospital’s Division of Gastroenterology, Hepatology and Nutrition, constipation is one of the most common diagnoses for which children are referred to pediatric GI across the United States. This large volume of referrals presented an opportunity to improve care outcomes by supporting decision- making in the primary care setting.
In an effort to address these challenges, the division joined with the hospital’s Integrated Care Program and the Pediatric Physician’s Organization at Children’s (PPOC) to launch a shared care/quality improvement initiative. This initiative armed primary care providers (PCPs) with education, decision-support tools, pre-referral diagnosis and management advice about treating children with constipation. The primary goal of the study was to investigate whether a “shared care” model might reduce unnecessary referrals and improve adherence to established clinical guidelines.
Notes sat down with Richard Antonelli, MD—Boston Children’s medical director of integrated care and one of the initiative’s leaders—to discuss the initiative, its results (recently reported in Pediatrics) and what he and his colleagues learned about how PCPs and GI specialists can work together to improve the management of constipation. …Read More