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.
Dr Tan and colleagues identified demographic and clinical predictors of healthcare utilization among veterans with IBD.
The research team 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.
The team estimated annual number of IBD-related visits 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.
Overall, the team found that 676 patients had mean 3 IBD-related encounters annually.
The researchers observed that CD patients had almost 4 encounters compared to 3 in UC.
The team noted that Hispanics had less visits compared to Caucasians and African-Americans, current smokers had more visits than never smokers, and first IBD visit at age <40 had more visits than age >65.
UC pancolitis was associated with more visits than proctitis.
The research team found that CD penetrating phenotype was associated with more encounters than inflammatory type.
Dr Tan's team comments, "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."