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Determinants of Healthcare Utilization Among Veterans with Inflammatory Bowel Disease.
- Source :
-
Digestive Diseases & Sciences . Mar2017, Vol. 62 Issue 3, p607-614. 8p. - Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>Identifying patient-level and disease-specific predictors of healthcare utilization in inflammatory bowel disease (IBD) may allow targeted interventions to reduce costs and improve outcomes.<bold>Aim: </bold>To identify demographic and clinical predictors of healthcare utilization among veterans with IBD.<bold>Methods: </bold>We conducted a single-center cross-sectional study of veterans with IBD from 1998 to 2010. Demographics and disease characteristics were abstracted by manual chart review. Annual number of IBD-related visits was estimated by dividing total number of IBD-related inpatient and outpatient encounters by duration of IBD care. Associations between predictors of utilization were determined using stepwise multivariable linear regression.<bold>Results: </bold>Overall, 676 patients (56% ulcerative colitis (UC), 42% Crohn's disease (CD), and 2% IBD unclassified (IBDU)) had mean 3.08 IBD-related encounters annually. CD patients had 3.59 encounters compared to 2.73 in UC (p < 0.01). In the multivariable model, Hispanics had less visits compared to Caucasians and African-Americans (2.09 vs. 3.09 vs. 3.42), current smokers had more visits than never smokers (3.54 vs. 2.43, p = 0.05), and first IBD visit at age <40 had more visits than age >65 (3.84 vs. 1.75, p = 0.04). UC pancolitis was associated with more visits than proctitis (3.47 vs. 2.15, p = 0.04). CD penetrating phenotype was associated with more encounters than inflammatory type (4.68 vs. 4.15, p = 0.04).<bold>Conclusions: </bold>We found that current tobacco use, age <40 at first IBD visit, UC pancolitis, and CD fistuilizing phenotype in addition to Caucasian and African-American race were independent predictors of increased healthcare utilization. Interventions should be targeted at these groups to decrease healthcare utilization and costs. [ABSTRACT FROM AUTHOR]
- Subjects :
- *INFLAMMATORY bowel diseases
*MEDICAL care of veterans
*CROHN'S disease
*ULCERATIVE colitis
*CIGARETTE smokers
*PROCTITIS
*INFLAMMATORY bowel disease treatment
*AGE factors in disease
*BLACK people
*VETERANS
*SMOKING
*WHITE people
*COST analysis
*CROSS-sectional method
*SEVERITY of illness index
*PATIENTS' attitudes
*ECONOMICS
*THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 01632116
- Volume :
- 62
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Digestive Diseases & Sciences
- Publication Type :
- Academic Journal
- Accession number :
- 121387089
- Full Text :
- https://doi.org/10.1007/s10620-016-4414-9