Quality of health care in inflammatory bowel disease and its assessment

SUMMARY Patients with inflammatory bowel disease (IBD) are consistently high users of health care services. They need continuous medication, frequent follow up visits, while their life expectancy is normal. One major parameter, which creeps into the assessment of quality of care, is organization of health care system. However, relatively little research exists on the characteristics and the organization of an ideal health care system which will effectively satisfy the needs of the chronically ill patient. Regarding money spent on chronic illnesses in terms of societal costs, IBD is less costly than, for example, coronary diseases, since loss of work hours, disability, or early death are less common. In terms of pure economic costs, IBD patients can be more costly than other chronic patients depending on age of disease onset and severity of illness. Crohnis disease patients consider cost aspects as an important element of quality more than ulcerative colitis patients do. Standard framework for the assessment of quality of care remains Donabedianis approach according to the Structure-Process-Outcome characterization. Lack of information is associated with more disease related worries and concerns of patients and, accordingly, with decreased quality of life. Finally, the patientis perception about high quality health care and his/ her satisfaction as a iconsumeri of health care services are extremely important issues for assessing quality of health care.