P4262 - Black Patients with Inflammatory Bowel Disease Have Higher Healthcare Utilization Trends than White Patients

Landen Shane Burstiner, DO, MSc¹, Tomas Potlach, BS², Anvit D. Reddy, DO¹, Nadim A. Qadir, DO³, Gerardo Diaz Garcia, DO¹, Luke Stachler, MD¹, Tara Kronen, DO, MA¹, Yasmeen Saker, MD⁴, Maged A.. Ghali, MD¹, Ellen M. Zimmermann, MD⁵, Naueen A. Chaudhry, MD, MS^5
1University of Florida College of Medicine, Jacksonville, FL; ²University of Florida College of Medicine, Miami, FL; ³University of Florida College of Medicine, Windermere, FL; ⁴University of Florida College of Medicine, Gainesville, FL; ⁵University of Florida, Gainesville, FL

Introduction: Patients with Inflammatory Bowel Disease (IBD) require comprehensive medical management which sometimes leads to high utilization of healthcare resources. Systemic biases in healthcare propagate unequal access, treatment, and outcomes, disproportionately affecting minority populations. Although racial disparities in IBD have been increasingly documented, further work is needed to accurately assess differences in outpatient gastroenterology clinic visits, emergency department (ED) visits, hospitalizations, and colonoscopies among underrepresented groups. Previous studies reported black patients were less likely than white patients to be under the care of a gastroenterologist and were more likely to rely on the ED for their acute care needs, but had no difference in hospitalization rates.

Methods: A total of 7750 patients seen from 2012 to 2023 at two different tertiary health care systems in the Southeastern United States with at least three ICD 9 or 10 diagnosis codes for IBD were included. Under an IRB-approved protocol, patient demographics and healthcare utilization details were exported from electronic medical records into a database. Statistical tests were employed using Chi-square and t-test.

Results: Similar proportions of black patients and white patients with IBD received outpatient care in gastroenterology clinic (p=0.64) and underwent at least one colonoscopy (p=0.26). On average, black patients with IBD had a significantly higher number of colonoscopies (p< 0.001), gastroenterology clinic visits (p=0.011), emergency department visits (p< 0.001), and hospitalizations (p< 0.001). Black patients had longer hospital stays on average (p=0.001). See Table 1 for additional results.

Discussion: Our study demonstrated black patients with IBD used healthcare services considerably more frequently than white patients with IBD. In our population, contrary to prior literature, there does not appear to be a systemic lack of access to care based on race, as similar proportions of black and white patients were seen by a gastroenterologist in clinic and underwent a colonoscopy. There are significant limitations associated with our study, including its retrospective nature. Our study focused on all-cause healthcare utilization, however, our next steps are to focus specifically on IBD-related ED visits and hospitalizations and stratify based on disease severity, insurance status and healthcare hyperutilizers to identify the underlying cause of these patterns.


Disclosures:


Landen Shane Burstiner, DO, MSc¹, Tomas Potlach, BS², Anvit D. Reddy, DO¹, Nadim A. Qadir, DO³, Gerardo Diaz Garcia, DO¹, Luke Stachler, MD¹, Tara Kronen, DO, MA¹, Yasmeen Saker, MD⁴, Maged A.. Ghali, MD¹, Ellen M. Zimmermann, MD⁵, Naueen A. Chaudhry, MD, MS⁵. P4262 - Black Patients with Inflammatory Bowel Disease Have Higher Healthcare Utilization Trends than White Patients, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.