Heartburn Center Successfully Centralizes Care in a Community Setting

A multispecialty, comprehensive heartburn center in a community setting is positioned to provide optimal care from initial consultation and diagnosis through surgical intervention, when needed, as well as high levels of patient satisfaction, according to a case report in Frontiers in Medicine.

“In this article, we reported our approach to a practice model of an integrated heartburn center  based on our experience at our facility,” wrote authors from the Heartburn Center at St. Joseph’s Health, Liverpool, New York. “The integrated approach drove quality and efficiency in terms of coordinated care that enabled care cross-over and efficient resource utilization.”

The case study focused on the initial cohort of 832 patients treated at the center. Among them, almost a third had gastroesophageal reflux disease (GERD) for 12 years or more, while about 60% had GERD for at least 1 year and up to 11 years. More than 20% had been on proton pump inhibitors for 12 years or longer.

In more than a quarter of patients, GERD symptoms were atypical. The prevalence of Barrett’s esophagus was 4.6%—up to 10 times that of the general population, according to the study. Seven patients underwent radiofrequency ablation for Barrett’s esophagus, and two patients received endoscopic mucosal resection for dysplasia related to Barrett’s esophagus. Fifty of the 832 patient cases required consultation with other specialists.

Despite a 75% increase in patient referrals compared with patient volumes prior to set-up of the heartburn center, conversion rates from diagnosis to anti-reflux surgery remained consistent (around 25%), the authors reported. Health-related quality of life consistently improved among patients post-surgery. Furthermore, length-of-stay after anti-reflux procedures decreased more than 50% over 2 years, resulting in significant cost savings for the hospital.

“While centralization of GERD care is known to improve outcomes, in this case study we demonstrated the clinical success and commercial viability of centralizing GERD care in a community setting…” the authors wrote. “The approach is reproducible and may allow hospitals to set up their own heartburn centers of excellence, strengthening patient-community relationships and establishing scientific and clinical GERD leadership.”

Reference:
Maini A, Sun J, Buniak B, et al. Heartburn center set-up in a community setting: engineering and execution. Front Med (Lausanne). 2021;8:662007. doi:10.3389/fmed.2021.662007