DAY 2: Disparities in IBD Care

Aaron Tabibzadeh, MD, from New York University Langone Health, described the findings from qualitative focus group discussions with 23 adult patients with Crohn’s disease (CD) or ulcerative colitis (UC) receiving care in a safety-net healthcare setting and private academic IBD center in New York. Commonly identified barriers to IBD care included insurance approval delays, long wait times, transportation issues, and limited access to providers. Patients also described challenges with affordability of dietary recommendations and frustration with billing and insurance, which contribute to emotional and mental strain. (P1051)

Saad Saadat, MD, from Indiana University School of Medicine, conducted a retrospective cohort study of 25,430 patients with IBD from the TriNetX national database. Using propensity score matching for 28 covariates, patients were grouped into those with or without at least one ICD-10 code for a social determinant of health (SDOH; education/literacy, environment, housing, upbringing, and support). Compared to patients without an SDOH code, the SDOH cohort had a significantly higher risk ratio for emergency department (ED) visits, inpatient admissions, intensive care unit (ICU) admissions, and mortality. They also had a higher risk for fistulation, obstruction, perforation, and elevated inflammatory biomarkers, as well as greater use of opioid medications. Finally, the SDOH group was more likely to have received corticosteroids and less likely to have received an immunomodulator or biologic therapy. (P1057)

Sameh Gomaa, MD, from Phoenixville Hospital – Tower Health, conducted a retrospective cohort study of 105,488 patients with IBD in the TriNetX database who were propensity matched 1:1 by demographics, prior medication use, and comorbid conditions into two cohorts of White and African American patients. White patients were 17% more likely to initiate treatment with a biologic, and African Americans were more often started on corticosteroid therapy. African Americans were also more likely to undergo colectomy and present to the ED for IBD care. (P3165)

Yujin Jeong, MD, from Elmhurst Hospital Center, Ichan School of Medicine at Mount Sinai, utilized Global Burden of Disease data to evaluate global patterns of IBD from 1990 to 2021. Global prevalence of IBD increased from 2.17 million to 3.83 million, with China showing the greatest increase and Italy the lowest. The annual percent change in IBD prevalence significantly increased across low- and middle-income countries in Asia, Africa and Latin America. Death rate and disability-adjusted life years have declined over time. The incidence of IBD in 2021 was highest among patients 40-44 years of age, suggesting a shift toward earlier onset. (P5316)