{
  "abstract": "Objectives Unplanned hospital admissions are common for people with inflammatory bowel disease (IBD). While clinical predictors of admission are well-documented, research is limited exploring the healthcare delivery factors and system inequalities that contribute to these events.Design An online survey, distributed via the UK and European professional networks, and semi-structured interviews explored clinicians’ views of admission types, causes and barriers to preventing admissions. Clinicians ranked causes and barriers to preventing admissions, analysed by descriptive statistics and Friedman and Wilcoxon rank tests. We used framework analysis, guided by Candidacy Theory, to analyse qualitative data across data types to explore issues of healthcare access.Results 80 clinicians completed the survey, 13 were interviewed. For all unplanned IBD admissions, an unpreventable disease progression was ranked the highest cause (mean rank (MR) 32.20/100) (p<0.05), followed by missed opportunities for earlier intervention (MR 22.39/100) and patient access issues (MR 19.52/100). Qualitative interviews elaborated on avoidable unplanned admissions through: (1) missed opportunities in outpatient or primary care, (2) critical delays in specialised care and (3) system constraints blocking timely action. Key challenges in preventing admissions across the study related to patient navigation of services, organisational barriers, provider decision-making, and structural issues that impede access to care.Conclusions Most avoidable admissions were perceived not as a failure of individuals but a reflection of broader service inefficiencies and inequities. Reducing IBD admissions requires systemic investment and improvements in care navigation, rapid-access pathways, professional decision-making, patient education and service integration.",
  "authors": [
    {
      "affiliations": [
        "Sheffield Centre for Health and Related Research, The University of Sheffield, Sheffield, UK"
      ],
      "name": "Rachel Louise Hawkins"
    },
    {
      "affiliations": [
        "Department of Applied Health Sciences, University of Birmingham, Birmingham, UK"
      ],
      "name": "Matthew Lee"
    },
    {
      "affiliations": [
        "Sheffield Centre for Health and Related Research, The University of Sheffield, Sheffield, UK"
      ],
      "name": "Fiona Clare Sampson"
    },
    {
      "affiliations": [
        "School of Healthcare, University of Leeds School of Healthcare, Leeds, UK"
      ],
      "name": "Daniel Hind"
    },
    {
      "affiliations": [
        "Inflammatory Bowel Disease Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"
      ],
      "name": "Alan J Lobo"
    }
  ],
  "title": "‘We need to highlight as a community that these are avoidable’: exploring clinician perspectives on healthcare access and avoidable admissions in inflammatory bowel disease",
  "uid": "21ad38d0-74fd-5e3e-8ee2-a03d4f2cbf29"
}