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Mandatory Gastro Consult Boosts Care in Decompensated Cirrhosis

Significantly higher quality indicator score for mandatory consultation group versus usual care

Mandatory Gastro Consult Boosts Care in Decompensated Cirrhosis

WEDNESDAY, Jan. 7, 2015 (HealthDay News) -- For patients hospitalized with decompensated cirrhosis (DC), a gastroenterology mandatory consultation (MC) can improve the quality of care, according to a study published online Dec. 30 in the Journal of Hospital Medicine.

Rony Ghaoui, M.D., from Baystate Medical Center in Springfield, Mass., and colleagues examined the impact of an MC intervention on adherence to quality indicators (QIs) in patients with DC, and compared outcomes with usual care. Data were collected in a prospective cohort study with historic controls; participants included 303 patients who were observed in 695 hospitalizations. For each group, the scores were calculated per admission as the proportion of QIs met versus QIs for which the patient was eligible.

The researchers found that the QI score was significantly higher in the MC group (77.0 percent) than in the usual-care group (46.0 percent; P < 0.001), indicating improved management of ascites and documentation of transplant evaluation. There was also an improvement in management of variceal bleeding which did not reach statistical significance.

"The MC intervention was associated with greater adherence to recommended care but was not powered to detect difference in length of stay, readmission, or mortality rates," the authors write.

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