scholarly journals Differences in healthcare expenditures for inflammatory bowel disease by insurance status, income, and clinical care setting

2014 ◽  
Author(s):  
Michelle Park ◽  
Jay Bhattacharya ◽  
KT Park
Keyword(s):  
Inflammatory Bowel Disease ◽  
Low Income ◽  
Bowel Disease ◽  
Clinical Care ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Status ◽  
Inflammatory Bowel ◽  
Publicly Insured ◽  
Insured Patients

Background: Socioeconomic factors and insurance status have not been correlated with differential use of healthcare services in inflammatory bowel disease (IBD). Aim: To describe IBD-related expenditures based on insurance and household income with the use of inpatient, outpatient, emergency, and office-based services, and prescribed medications in the United States (US). Methods: We evaluated the Medical Expenditure Panel Survey from 1996 to 2011 of individuals with Crohn’s disease (CD) or ulcerative colitis (UC). Nationally weighted means, proportions, and multivariate regression models examined the relationships between income and insurance status with expenditures. Results: Annual per capita mean expenditures for CD, UC, and all IBD were $10,364 (N=238), $7,827 (N=95), and $9,528, respectively, significantly higher than non-IBD ($4,314, N=276,372, p<0.05). Publicly insured patients incurred the highest costs ($18,067), over privately insured ($8,014, p<0.05) or uninsured patients ($5,129, p<0.05). Among all IBD patients, inpatient care composed the highest proportion of costs ($3,392, p<0.05). Inpatient costs were disproportionately higher for publicly insured patients. Public insurance had higher odds of total costs than private (OR 2.13, CI 1.08-4.19) or no insurance (OR 4.94, CI 1.26-19.47), with increased odds for inpatient and emergency care. Private insurance had higher costs associated with outpatient care, office-based care, and prescribed medicines. Low-income patients had lower costs associated with outpatient (OR 0.38, CI 0.15-0.95) and office-based care (OR 0.21, CI 0.07-0.62). Conclusions: In the US, high inpatient utilization among publicly insured patients is a previously unrecognized driver of high IBD costs. Bridging this health services gap between SES strata for acute care services may curtail direct IBD-related costs.

scholarly journals Differences in healthcare expenditures for inflammatory bowel disease by insurance status, income, and clinical care setting

2014 ◽  
Author(s):  
Michelle Park ◽  
Jay Bhattacharya ◽  
KT Park
Keyword(s):  
Inflammatory Bowel Disease ◽  
Low Income ◽  
Bowel Disease ◽  
Clinical Care ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Status ◽  
Inflammatory Bowel ◽  
Publicly Insured ◽  
Insured Patients

Background: Socioeconomic factors and insurance status have not been correlated with differential use of healthcare services in inflammatory bowel disease (IBD). Aim: To describe IBD-related expenditures based on insurance and household income with the use of inpatient, outpatient, emergency, and office-based services, and prescribed medications in the United States (US). Methods: We evaluated the Medical Expenditure Panel Survey from 1996 to 2011 of individuals with Crohn’s disease (CD) or ulcerative colitis (UC). Nationally weighted means, proportions, and multivariate regression models examined the relationships between income and insurance status with expenditures. Results: Annual per capita mean expenditures for CD, UC, and all IBD were $10,364 (N=238), $7,827 (N=95), and $9,528, respectively, significantly higher than non-IBD ($4,314, N=276,372, p<0.05). Publicly insured patients incurred the highest costs ($18,067), over privately insured ($8,014, p<0.05) or uninsured patients ($5,129, p<0.05). Among all IBD patients, inpatient care composed the highest proportion of costs ($3,392, p<0.05). Inpatient costs were disproportionately higher for publicly insured patients. Public insurance had higher odds of total costs than private (OR 2.13, CI 1.08-4.19) or no insurance (OR 4.94, CI 1.26-19.47), with increased odds for inpatient and emergency care. Private insurance had higher costs associated with outpatient care, office-based care, and prescribed medicines. Low-income patients had lower costs associated with outpatient (OR 0.38, CI 0.15-0.95) and office-based care (OR 0.21, CI 0.07-0.62). Conclusions: In the US, high inpatient utilization among publicly insured patients is a previously unrecognized driver of high IBD costs. Bridging this health services gap between SES strata for acute care services may curtail direct IBD-related costs.

scholarly journals Why is there Low utilization of Biosimilars in Inflammatory Bowel Disease Patients by Gastroenterology Advanced Practice Providers?

2021 ◽  
Author(s):  
Nana Bernasko ◽  
Kofi Clarke
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Clinical Care ◽  
The United States ◽  
Advanced Practice ◽  
Medical Specialties ◽  
Healthcare Settings ◽  
The Usa ◽  
Knowledge Practice ◽  
Inflammatory Bowel

Abstract Aim To assess knowledge, practice patterns and attitudes towards the use of biosimilars by Advanced Practice Providers (APPs) treating patients with Inflammatory Bowel Disease (IBD). Background APPs provide care in a variety of healthcare settings including medical specialties. In Gastroenterology, they are an integral part of providing care to a complex group of patients with IBD. There has been an increase in options of medical therapies for treating IBD. These include small molecules, biologics and biosimilars. Adoption of biosimilars for treatment of IBD patients by gastroenterologists in the USA compared to Europe has been slow for several reasons. There is lack of data on their use by Advanced Practice Providers who provide frontline IBD clinical care in the United States. Methods Questionnaire based survey of APPs attending Gastroenterology conferences with a focus on IBD. Results Advanced Practice Providers in gastroenterology do not routinely consider the use of biosimilars in their practice. Conclusion There is low utilization of biosimilars in treating IBD patients by APPs. In addition, there are significant concerns about risk of side effects as well as perceived lack of APP targeted educational resources.

scholarly journals P326 An exploratory analysis of the impact of COVID-19 on colonoscopy procedures and new biologic treatment initiation among patients with Inflammatory Bowel Disease in the United States

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S350-S351
Author(s):  
R Ungaro ◽  
B Chou ◽  
J Mo ◽  
L Ursos ◽  
R Twardowski ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Claims Data ◽  
Clinical Care ◽  
The United States ◽  
Exploratory Analysis ◽  
Biologic Treatment ◽  
Inflammatory Bowel ◽  
New Treatment ◽  
The Impact

Abstract Background Patients with inflammatory bowel disease (IBD) require frequent colonoscopies to optimize disease management and treatment strategies. At the onset of the COVID-19 pandemic, many routine procedures were postponed to reduce the overall burden on healthcare systems. We characterized the impact of COVID-19 on IBD care by conducting an exploratory analysis of real-world US healthcare claims data to identify changes in treatment patterns and the number of colonoscopy procedures performed in patients with IBD during the first wave of the pandemic. Methods De-identified, open-source health insurance claims data, from Jan 2019 to Oct 2020, were obtained from the Symphony Health Integrated Dataverse® for US adults aged 18–80 years with IBD. Four outcome measures were used: number of colonoscopies performed; number of new biologic treatment initiations or treatment switches; number of new biologic treatment initiations or treatment switches in patients who had a colonoscopy within the previous 60 days; and rate of telehealth consultations per 1000 patients per month. Results During Jan–Dec 2019 and Jan–Oct 2020, 1.54 million and 1.29 million patients with IBD, respectively, were included. The bimonthly number of colonoscopies remained stable throughout 2019, with a maximum change of +5.4% in Jul–Aug (N = 49947) vs Jan–Feb 2019 (N = 47399). Colonoscopy use decreased by 4.7% in Jan–Feb 2020 (N = 45167) vs the same period in 2019. In Mar–Apr 2020, colonoscopy numbers decreased by 55.3% (N = 20191) vs Jan–Feb 2020 (Figure 1a); a reduction of 59.4% vs Mar–Apr 2019 (N = 49780). In May–Jun 2020 (−23.8%) and Jul–Aug 2020 (+2.0%) the difference vs Jan–Feb 2020 gradually decreased (Figure 1a). Bimonthly numbers of new treatment initiations or treatment switches in 2019 varied by up to 6.9% vs Jan–Feb 2019. In May–Jun 2020, numbers of new treatment initiations or treatment switches decreased by 17.0% (N = 10072) vs Jan–Feb 2020 (N = 12133) (Figure 1b); a decrease of 19.3% vs May–Jun 2019 (N = 12488). The number of new treatment initiations or treatment switches in patients who had a colonoscopy within the previous 60 days decreased by 42.5% (N = 892) in Mar–Apr 2020 vs Jan–Feb 2020 (N = 1551) (Figure 1c); a decrease of 44.2% vs Mar–Apr 2019 (N = 1599). Telehealth utilization increased in March 2020 and remained higher than in 2019 up to October 2020 (Figure 2). Conclusion Reduction in colonoscopies and subsequent initiation/switching of treatments during the COVID-19 pandemic first wave suggests lost opportunities for therapy optimization that may have an impact on longer-term patient outcomes. Increased utilization of telehealth services may have helped address gaps in routine clinical care.

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