ArticleDigestive diseases and sciences2010
GERD-related health care utilization, therapy, and reasons for transfer of GERD patients between primary care providers and gastroenterologists in a US managed care setting.
Article in Digestive diseases and sciences, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 24 citations in OpenAlex.
- Network meta-analysis of multiple doses of vonoprazan for the treatment of erosive esophagitis.Journal of comparative effectiveness research · 2023Review
- Healthcare Resource Utilization and Costs Among Patients With Gastroesophageal Reflux Disease, Barrett's Esophagus, and Barrett's Esophagus-Related Neoplasia in the United States.Journal of health economics and outcomes research · 2023Article
- Considerations When Aggregating Data to Measure Performance Across Levels of the Health Care System.Academic pediatrics · 2022Article
- Knowledge and practice of family medicine and internal medicine residents toward the management of gastroesophageal reflux disease in Riyadh, Saudi Arabia.Journal of family medicine and primary care · 2021Article
- Article
- Heartburn Center Set-Up in a Community Setting: Engineering and Execution.Frontiers in medicine · 2021Article
- Awareness, experience, and practice of physicians regarding adult gastroesophageal reflux disease (GERD) in Riyadh, Saudi Arabia.Journal of family medicine and primary care · 2020Article
- Magnetic sphincter augmentation: Optimal patient selection and referral care pathways.World journal of gastrointestinal endoscopy · 2019Review
- Characterizing idiopathic pulmonary fibrosis patients using US Medicare-advantage health plan claims data.BMC pulmonary medicine · 2019Article
- Article
- Management of Gastrointestinal Disorders in Central and Eastern Europe: Self-Reported Practice of Primary Care Physicians.Zdravstveno varstvo · 2014Article
- The role of primary care physicians in early diagnosis and treatment of chronic gastrointestinal diseases.International journal of general medicine · 2014Review
- Regional differences in healthcare delivery for gastroparesis.Digestive diseases and sciences · 2013Article
- The value of branded proton pump inhibitors: formulary considerations.P & T : a peer-reviewed journal for formulary management · 2011Article
- What causes treatment failure - the patient, primary care, secondary care or inadequate interaction in the health services?BMC health services research · 2011Article
- Characterizing Health Outcomes in Idiopathic Pulmonary Fibrosis using US Health Claims Data.Respiration; international review of thoracic diseasesArticle
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePatient flow between primary care physicians and gastroenterologists in the continuum of gastroesophageal reflux disease (GERD) care is poorly understood. Using administrative claims data from a large US health plan linked with data abstracted from medical records, we examined: health care resource utilization for GERD subjects treated by primary care physicians (PCPs) and gastroenterologists (GEs), determinants of GERD subject transfer between these physician types, and reasons for GERD therapy change.
resultsWithin a sample of 169,884 patients, 211,043 PCP-based episodes of care and 40,304 GE-based episodes of care were developed. In unadjusted comparisons, GE episodes were characterized by more endoscopic procedures, on average (50.5/100 episodes), compared with PCP episodes (6.3/100, P < 0.001). Multivariate analysis showed that patients with esophagitis had 57.3% higher odds (P < 0.01) of transfer from PCP to GE compared with patients without esophagitis; patients with esophageal stricture had 98.6% higher odds (P < 0.01) of PCP-GE transfer. Patients with endoscopy during a first GE episode had 32.2% higher odds of transfer to a PCP (P < 0.01). The principal reasons for change in GERD therapy were no change or worsening of symptoms (51.7% of PCP charts; 9.5% of GE charts) and lack of response to therapy (51.7% of PCP charts, 26.2% of GE charts).
conclusionResource utilization varies greatly based on the physician's specialty. We infer that timely transfer of GERD patients to gastroenterologists when empiric treatment is insufficient may lead to more efficient clinical management.
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