Evaluating Patient Outcomes and Healthcare Utilization After the Introduction of an Advanced Therapy Care Pathway for Inflammatory Bowel Disease: A Multicenter, Prospective Quasi-Experimental Study in the Netherlands

By
Elyke H Visser
Martijn A Oude Voshaar
Reinier C A Van Linschoten
Jildou Hoekstra
Kristin Robbers
Vincent de Jonge
Edith Koehler
K Evelyne Verweij
Sanne van der Wiel
Daniëlle van der Horst
C Janneke van der Woude
Desiree van Noord
Rachel L West
on behalf of the Southwest Netherlands IBD Study Group
October 1, 2026

Bmj Open Gastroenterology

Objective:

To evaluate the influence of an advanced therapy care pathway (ACP) on outcomes, healthcare utilization, and treatment variation among individuals with inflammatory bowel disease (IBD) in the Netherlands.

Approach:

Study Design: A multicentre, prospective quasi-experimental study comparing preimplementation (December 2020–December 2021) and postimplementation (March 2022–March 2023) periods.
Data Collection: Outcomes were obtained through electronic medical records and validated questionnaires, following the International Consortium for Health Outcomes Measurement standard set.
Analysis Method: Difference-in-differences (DiD) analysis was used to assess the ACP’s effect.

Key Findings:

1173 patients included, with a median age of 45 years and 55% female.
Crohn’s disease accounted for 64% of cases.
Disease control remained high and unchanged post-implementation (DiD-estimate: 0.12, 95% CI −0.74 to 1.01).
Emergency room visits decreased significantly six months post-implementation (DiD-estimate visits: −0.05, 95% CI −0.10 to 0.01), and hospital admissions decreased significantly, with only the reduction in admissions attributable to the ACP (DiD-estimate admissions: −0.06, 95% CI −0.11 to −0.03).

Limitations:

The study is quasi-experimental, which may limit causal inference.
Results are based on a specific population in the Netherlands, which may not be generalizable.

Conclusion:

Implementing a structured minimum care standard for patients with IBD receiving advanced therapies may lower unplanned healthcare utilization without compromising outcomes.