Are Inflammatory Bowel Disease Patients With Diabetes Mellitus at Increased Risk for Poor Outcomes Including Greater Health Care Utilization?

2020 ◽  
Vol 26 (9) ◽  
pp. 1443-1444
Author(s):  
Uni Wong ◽  
Raymond K Cross
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Health Care Utilization ◽  
Bowel Disease ◽  
Care Utilization ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Inflammatory Bowel ◽  
Active Disease

Inflammatory bowel disease patients with diabetes mellitus are more likely to have active disease, report worse quality of life, and have higher health care utilization. This high-risk subgroup of patients with confirmed active disease should be treated with appropriate medical therapy including biologic therapy with or without an immunosuppressant.

scholarly journals A183 TELEHEALTH USE IN RURAL SASKATCHEWAN AND INFLAMMATORY BOWEL DISEASE OUTCOMES

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 197-199
Author(s):  
M Patterson ◽  
M Gozdzik ◽  
J Peña-Sánchez ◽  
S Fowler
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Health Care Utilization ◽  
Bowel Disease ◽  
Postal Code ◽  
Care Utilization ◽  
Specialist Care ◽  
Disease Characteristics ◽  
Significant Difference ◽  
Inflammatory Bowel

Abstract Background Appropriate management of inflammatory bowel disease (IBD) often requires multiple specialist appointments per year. Living in rural locations may pose a barrier to regular specialist care. Saskatchewan (SK) has a large rural population. Prior to COVID-19, telehealth (TH) in SK was not routinely used for either patient assessment or follow up. Furthermore, TH was exclusively between hospitals and specific TH sites without direct contact using patient’s personal phones. Aims The objective of this study was to assess the differences in demographics, disease characteristics, outcomes, and health care utilization between patients from rural SK with IBD who used TH and those who did not. Methods A retrospective chart review was completed on all rural patients (postal code S0*) with IBD in SK who were followed at the Multidisciplinary IBD Clinic in Saskatoon between January 2018 and February 2020. Patients were classified as using TH if they had ever used it. Information on demographics, disease characteristics, and access to IBD-related health care in the year prior to their last IBD clinic visit or endoscopy was collected. Data was not collected for clinic visits after March 1, 2020 as all outpatient care became remote secondary to the COVID-19 pandemic. Mean, standard deviations, median and interquartile ranges (IQR) were reported. Mann-Witney U and Chi-Square tests were used to determine differences between the groups. Results In total, 288 rural SK IBD patients were included, 30 (10.4%) used TH and 258 (89.6%) did not. Patient demographics were not significantly different between the two groups; although, there was a statistically significant difference in the proportion of ulcerative colitis patients (17% TH vs. 38% non-TH, p=0.02). The percentage of patients with clinical remission was 87% for TH patients and 74% for non-TH patients (p=0.13). There were no significant differences in health care utilization patterns and biochemical markers of disease, including c-reactive protein (CRP) and fecal calprotectin (FCP) (p>0.05). Conclusions Prior to the pandemic, a small percentage of patients with IBD in rural SK ever used TH. A small proportion of UC patients used TH. No significant differences in disease characteristics, outcomes, or health care utilization were identified. Further study is warranted to identify barriers to use of this technology to tailor care to this patient group and improve access to care, especially now as the COVID-19 pandemic has drastically changed the use of virtual care. Funding Agencies None

Quality of Care Program Reduces Unplanned Health Care Utilization in Patients With Inflammatory Bowel Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Gil Y. Melmed ◽  
Brant Oliver ◽  
Jason K. Hou ◽  
Donald Lum ◽  
Siddharth Singh ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Quality Of Care ◽  
Health Care Utilization ◽  
Bowel Disease ◽  
Care Program ◽  
Care Utilization ◽  
Inflammatory Bowel

scholarly journals Predictors of High Health Care Utilization in Patients With Inflammatory Bowel Disease Within 1 Year of Establishing Specialist Care

2020 ◽  
Author(s):  
Kenechukwu Chudy-Onwugaje ◽  
Alexander P Mamunes ◽  
David A Schwartz ◽  
Sara Horst ◽  
Raymond K Cross
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Health Care Utilization ◽  
Bowel Disease ◽  
The United States ◽  
Care Utilization ◽  
Medical Assistance ◽  
High Utilizers ◽  
Inflammatory Bowel ◽  
Hospital Visits

Abstract Background A small proportion of patients with inflammatory bowel disease (IBD) consume a disproportionate amount of health care resources, with most of these spent on unplanned care in emergency room (ER) and hospital visits. Interventions in those at high risk in the outpatient setting could reduce the need for future inpatient care. We sought to describe the characteristics predictive of high health care utilization within 1 year after an initial IBD clinic encounter. Methods This was a retrospective study of new IBD patients seen at the outpatient clinics of 2 tertiary IBD centers in the United States. Baseline sociodemographic and clinical characteristics were collected, and the number of IBD-related ER and hospital visits were recorded over the 1-year period after the initial clinic encounter. Patients with ≥2 visits (high utilizers) were compared with those with no visits. Results Of the 735 patients included in the final analysis, 106 (14.4%) were high utilizers, and they had a mean of 2.9 visits (maximum = 10) in the 1 year after their initial encounter. In multivariate analysis, insurance coverage through medical assistance (odds ratio [OR] 3.57; 95% confidence interval [CI], 1.38–9.20), steroid use (OR 1.83; 95% CI, 1.11–3.04), short inflammatory bowel disease questionnaire score <50 (OR 2.29; 95% CI, 1.23–4.27), and current ostomy (OR 4.82; 95% CI, 1.51–15.37) were independently associated with high utilization. Conclusions Multidisciplinary care and resources should be preferentially channeled towards new clinic patients with severe disease and on medical assistance, as this could reduce future inpatient visits and result in cost savings.

scholarly journals Self-reported Health Care Utilization of Patients with Inflammatory Bowel Disease Correlates Perfectly with Medical Records

2016 ◽  
Vol 22 (3) ◽  
pp. 688-693 ◽  
Author(s):  
Mirjam Severs ◽  
Roosmarijn E. Petersen ◽  
Peter D. Siersema ◽  
Marie-Josée J. Mangen ◽  
Bas Oldenburg
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Health Care Utilization ◽  
Bowel Disease ◽  
Medical Records ◽  
Care Utilization ◽  
Inflammatory Bowel ◽  
Reported Health

scholarly journals NHSR 152: Health Care Utilization Among U.S. Adults With Inflammatory Bowel Disease, 2015–2016

2021 ◽  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Health Care Utilization ◽  
Bowel Disease ◽  
Care Utilization ◽  
Inflammatory Bowel

This report measures health care utilization among adults with inflammatory bowel disease (IBD) as compared to adults without IBD.

Monocytosis Is a Biomarker of Severity in Inflammatory Bowel Disease: Analysis of a 6-Year Prospective Natural History Registry

2021 ◽  
Author(s):  
Alyce Anderson ◽  
Cynthia Cherfane ◽  
Benjamin Click ◽  
Claudia Ramos-Rivers ◽  
Ioannis E Koutroubakis ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Natural History ◽  
Crohn Disease ◽  
Bowel Disease ◽  
Disease Type ◽  
Care Utilization ◽  
Increased Risk ◽  
Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) is associated with alterations of the innate and adaptive immune systems. Monocytes respond to inflammation and infection, yet the relationship between monocytosis and IBD severity is not fully understood. We aimed to characterize the prevalence of monocytosis in IBD and the association between monocytosis and disease severity and IBD-related health care utilization. Methods We used a multiyear, prospectively collected natural history registry to compare patients with IBD with monocytosis to those without monocytosis, among all patients and by disease type. Results A total of 1290 patients with IBD (64.1% with Crohn disease; 35.9% with ulcerative colitis) were included (mean age 46.4 years; 52.6% female). Monocytosis was found in 399 (30.9%) of patients with IBD (29.3% with Crohn disease; 33.9% with ulcerative colitis). Monocytosis was significantly associated with abnormal C-reactive protein level and erythrocyte sedimentation rate, anemia, worse quality of life, active disease, and increased exposure to biologics (all P < 0.001). Compared with patients without monocytosis, patients with monocytosis had a 3-fold increase in annual financial health care charges (median: $127,013 vs. $32,925, P < 0.001) and an increased likelihood of hospitalization (adjusted odds ratio [AOR], 4.5; P < 0.001), IBD-related surgery (AOR, 1.9; P = 0.002), and emergency department (ED) use (AOR, 2.8; P < 0.001). Patients with monocytosis had a shorter time to surgery, hospitalization, and ED visit after stratifying by disease activity (all P < 0.05). Conclusions Patients with IBD with monocytosis, regardless of disease type, are at increased risk for worse clinical outcomes, hospitalization, surgery, and ED use. Peripheral monocytosis may represent a routinely available biomarker of a distinct subgroup with severe disease.

Longitudinal Trends in the Direct Costs and Health Care Utilization Ascribable to Inflammatory Bowel Disease in the Biologic Era

2020 ◽  
Vol 115 (1) ◽  
pp. 128-137 ◽  
Author(s):  
Laura E. Targownik ◽  
Gilaad G. Kaplan ◽  
Julia Witt ◽  
Charles N. Bernstein ◽  
Harminder Singh ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Health Care Utilization ◽  
Bowel Disease ◽  
Direct Costs ◽  
Care Utilization ◽  
Inflammatory Bowel
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