Virtual Multidisciplinary GI Care Clinic Improves Patient Engagement, Satisfaction, and Outcomes at Reduced Costs and Healthcare Utilization: A Prospective Cohort Study.

Abstract

Chronic gastrointestinal (GI) conditions, including irritable bowel syndrome and other disorders of gut-brain interaction (DGBIs), are prevalent and costly, and fragmented care contributes to suboptimal outcomes. Virtual and multidisciplinary care models may improve outcomes. We aimed to 1) characterize patients receiving virtual GI care, 2) report patient engagement with and patient-reported outcomes after virtual multidisciplinary care, 3) report healthcare utilization and costs from a payer perspective among patients versus propensity score-matched controls identified from claims data. We collected descriptive data on patient demographics, clinic provider visits, symptoms, and patient-reported outcomes from 3/2021-9/2022. To evaluate healthcare utilization and costs, we conducted difference-in-difference (DID) analyses using claims data compared with a propensity score-matched control group. Among 234 patients (71% female, mean age 45.4±13.2 years), 51% received a new GI diagnosis, predominately DGBI (63%). Engagement criteria were met by 80% (n=187), who completed a mean of 10 visits and median time-to-first appointment of 6 days. Dietitians (93%), psychologists (76%), and health coaches (64%) were frequently utilized. Engaged patients exhibited significant improvements from pre- to post-clinic in IBS severity (226.7 to 145.6), symptom control (20.2% to 86.6%), quality-of-life dysphoria (27.5 to 32.8), missed workdays (1.0 to 0.7), and satisfaction (37.4% to 96.3%) (all p<0.05). Compared with matched controls, a significantly smaller percent of patients had imaging (15% vs. 44%; p < 0.0001) and GI-related emergency department visits (4% vs. 10%; p =.0028), which contributed to reductions in GI-related costs ($443 PMPM; p=0.047) and all-cause costs ($676 PMPM; p=0.043), equating to annualized savings of $5,316 and $8,112, respectively. Virtual multidisciplinary GI care was associated with high engagement, improved clinical outcomes, and reduced healthcare utilization and costs.