P2552 - Understanding Health Insurance Related Challenges in Ulcerative Colitis: An Analysis of Reddit Discussions

Saeed Graham, MD¹, Terence DaSilva, BSc², Hassam Ali, MD³, Tierra Sanders, DO¹, Abdulazeez Swaiti, MD¹, Stephanie Ibarra, MD¹, Christin Wilkinson, MD¹, Asad Ur Rahman, MD^4
1East Carolina University, Greenville, NC; ²University of the West Indies, Osbourn, Saint John, Antigua and Barbuda; ³ECU Health Medical Center, Greenville, NC; ⁴Cleveland Clinic Florida, Weston, FL

Introduction: Ulcerative colitis is a chronic inflammatory condition of the colon with significant impact on patients' quality of life. As a chronic disease requiring recurring laboratory and procedural testing, frequent office visits, costly medications and sometimes hospitalization or surgery, health insurance is considered essential. Reddit is a vast network of communities where users can discuss various topics, share news, and support each other in niche forums known as subreddits. The subreddit r/UlcerativeColitis is a global online community specifically focused on supporting individuals who are living with ulcerative colitis. We analyzed the r/UlcerativeColitis subreddit using natural language processing methods to identify critical topics and patient perspectives in the online discourse about health insurance.

Methods: We analyzed submissions from the r/UlcerativeColitis subreddit, archived from June 2005 to December 2022. An iterative keyword-based search identified relevant submissions using terms related to insurance and healthcare costs. Principal component analysis was performed in RStudio, extracting five factors for analysis. Themes were generated using GPT-4o and representative submissions for each theme were analyzed using sentiment analysis techniques to generate polarity and subjectivity scores. Polarity scores indicate sentiment on a scale from -1 (very negative) to +1 (very positive). Subjectivity scores measure how subjective or objective a sentiment is, ranging from 0 (very objective) to 1 (very subjective).

Results: Of 24,096 submissions, 1,453 posts mentioning insurance-related terms were identified, with 1,165 original submissions after removing duplicates. Five themes were identified: (1) Symptoms and Daily Challenges, (2) Diagnosis and Management, (3) Biologic and Synthetic Small Molecule Treatments, (4) Challenges of Maintaining Income and Psychological Burdens, and (5) Coordination of Care. Sentiment analysis revealed some level of satisfaction with overall slightly positive sentiment scores but individual submission analysis revealed many bureaucratic hurdles.

Discussion: This study highlights salient issues faced by patients with ulcerative colitis in interaction with the health insurance sector particularly regarding treatment approval and the psychological burden of managing a chronic illness. It suggests a need for improved insurance policies and support systems to enhance patient care and reduce financial and emotional stress for ulcerative colitis patients.



Disclosures:


Saeed Graham, MD¹, Terence DaSilva, BSc², Hassam Ali, MD³, Tierra Sanders, DO¹, Abdulazeez Swaiti, MD¹, Stephanie Ibarra, MD¹, Christin Wilkinson, MD¹, Asad Ur Rahman, MD⁴. P2552 - Understanding Health Insurance Related Challenges in Ulcerative Colitis: An Analysis of Reddit Discussions, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.