P840 Structural evaluation of Inflammatory Bowel Disease Comprehensive Care Units in Brazil

Abstract

Abstract Background In Brazil there is no methodology for evaluating health services recognized as Comprehensive Care Units (CCU), making it difficult to assess the quality of care provided for IBD patients. Aims: Map the distribution of this units and identify strengths and weaknesses, considering local and regional characteristics with a view to proposing a ranking system for Brazilian centers. Methods The study was carried out in three phases. First, GEDIIB developed 22 questions to characterize CCU in Brazil. The questionary was constructed based on GETECCU criteria. All GEDIIB members were invited to respond to the survey with the 11 questions considered most relevant. In the last phase, an analysis of the results obtained in the CCU was carried out, using the IBM SPSS Statistics v 29.0.1.0 software. Descriptive statistics were used to characterize the unit´s profile. The chi-square test was used to compare categorical variables Results There were 109 responses, 53 from public centers. Of these, 11 were excluded. Most units were concentrated in the Southeastern region 22 (52.4%) and only one (2.4%) in the Northern region of Brazil. Thirty-nine centers (92.9%) perform endoscopic procedures, but only 9 (21.4%) have access to enteroscopy and/or capsule endoscopy. Thirty-three centers (78.6%) offer infusion therapy locally, 26 (61.9%) maintain IBD patient records, 13 (31.0%) reported having an IBD nurse, 34 (81.0%) have specific evidence-based protocols and only 7 (16.7%) have a patient satisfaction methodology. In the private scenario there were 56 responses, of which 10 were excluded. There is also a concentration in the Southeastern and Southern regions. Thirty-nine centers (84.8%) have access to endoscopic procedures and 19 perform enteroscopy and/or capsule endoscopy. Infusion therapy is available in 24 centers (52.2%). Thirty-nine (84.8%) maintain a specific database of IBD patients, 17 (37%) have an IBD nurse, 36 (78.3%) have specific evidence-based protocols, and 22 (47.8%) apply a patient satisfaction methodology. Multidisciplinary teams (p< 0.002) and infusion centers (p< 0.01) predominate in public centers as compared to private ones. Telemedicine (p< 0.027), capsule endoscopy (p< 0.001), exclusive registration of patients with IBD (p< 0.015) and patient satisfaction methodologies (p< 0.002) are predominant in private centers as compared to public centers. Conclusion IBD CCU in Brazil were mainly located in the southeastern and southern regions of the country. Most centers have dedicated multidisciplinary teams and specialists involved in IBD treatment. There is still a current need to improve the proportion of nurses' involvement in IBD care in Brazil.