# Integrated Rheumatology-Gastroenterology Clinic: An Innovative Organisation for Patients with Multiple Autoimmune Diseases

## TL;DR

An integrated clinic for patients with joint and bowel autoimmune diseases improves care continuity and reduces fragmented healthcare.

## Contribution

The study introduces and evaluates an innovative integrated clinic for patients with multiple autoimmune diseases.

## Key findings

- Patients attending the integrated clinic had an average of 29.6 outpatient visits before integration.
- Relational continuity was identified as crucial for patient experiences in the integrated clinic.
- The approach may benefit other patients with comorbid conditions by bridging healthcare gaps.

## Abstract

Patients with multiple autoimmune diseases lack continuity of care due to increasing specialisation and siloed practice in healthcare. Despite improvements in quality, this organisation has led to fragmented patient pathways, as related diseases are treated separately. Limited research has investigated approaches to integrate care for patients with co-occurrent Inflammatory Joint Disease and Inflammatory Bowel Disease, with minimal emphasis on the patient perspective. The aim was to describe the Rheumatology-Gastroenterology Clinic (ReGa), characterise its population, and investigate patient experiences.

A Danish outpatient clinic combining rheumatology and gastroenterology.

During the study period, 54 patients attended the ReGa clinic. Prior to integration, these patients had an average of 29.6 outpatient visits. With most working-age patients, this frequent attendance poses individual and societal challenges. Based on Haggerty et al.’s definition of continuity of care, relational elements emerged as particularly important for patients but not independent of informational and management factors.

The integrated approach was experienced to improve continuity of care for patients with multiple autoimmune diseases. The findings highlight the potential to bridge healthcare gaps and address challenges arising from organisational structures shaped by specialisation and compartmentalisation of knowledge. This approach may also benefit other patient groups with comorbid conditions.