Abstract
Background: There is an increasing burden of inflammatory bowel disease (IBD) among the elderly. We sought to characterize health care utilization of elderly onset IBD. Methods: We identified incident IBD cases in Ontario, Canada between 1999 and 2008 and categorized subjects by age at diagnosis as young (18-40 yr), middle-age (41-64 yr), and elderly (≥65 yr). We compared IBD-specific health utilization indicators, including outpatient visits, emergency department visits, and hospitalizations. Results: The elderly accounted for 8.1% (N 725) and 11.6% (N 1749) of incident Crohn's disease (CD) and ulcerative colitis (UC), respectively. They were less likely than young adults to have any IBD-specific gastroenterology visit in the first year after diagnosis (CD, 63% versus 71%, P <0.001; UC, 63% versus 69%, P <0.001). They less frequently received continuous gastroenterology care (CD, 36% versus 46%, P <0.001; UC, 33% versus 43%, P <0.001). Elderly patients with IBD were less likely than young adults to require an IBD-specific emergency department visit in the first year (CD, 8.8% versus 18.5%, P <0.001; UC, 7.8% versus 11.6%, P <0.001). Similarly, elderly patients with CD exhibited lower hospitalization rates (incidence rate ratio, 0.62; 95% confidence interval, 0.59-0.65). Hospitalization rates were modestly higher among those elderly patients with UC compared with young adults during the first year (incidence rate ratio, 1.14; 95% confidence interval: 1.02-1.28), but this association reversed thereafter (incidence rate ratio, 0.64; 95% confidence interval: 0.57-0.71). Conclusions: Elderly patients with IBD exhibited lower IBD-specific health care utilization than young adults, which may reflect a multitude of factors including more benign disease and differential health care access.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 777-782 |
| Number of pages | 6 |
| Journal | Inflammatory Bowel Diseases |
| Volume | 21 |
| Issue number | 4 |
| DOIs | |
| State | Published - Mar 6 2015 |
| Externally published | Yes |
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Keywords
- Crohn's disease
- elderly
- inflammatory bowel disease
- ulcerative colitis
ASJC Scopus subject areas
- Gastroenterology
- Immunology and Allergy
- Medicine(all)
Cite this
Health Care Utilization in Elderly Onset Inflammatory Bowel Disease : A Population-based Study. / Nguyen, Geoffrey C.; Sheng, Lisa; Benchimol, Eric I.
In: Inflammatory Bowel Diseases, Vol. 21, No. 4, 06.03.2015, p. 777-782.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Health Care Utilization in Elderly Onset Inflammatory Bowel Disease
T2 - A Population-based Study
AU - Nguyen, Geoffrey C.
AU - Sheng, Lisa
AU - Benchimol, Eric I.
PY - 2015/3/6
Y1 - 2015/3/6
N2 - Background: There is an increasing burden of inflammatory bowel disease (IBD) among the elderly. We sought to characterize health care utilization of elderly onset IBD. Methods: We identified incident IBD cases in Ontario, Canada between 1999 and 2008 and categorized subjects by age at diagnosis as young (18-40 yr), middle-age (41-64 yr), and elderly (≥65 yr). We compared IBD-specific health utilization indicators, including outpatient visits, emergency department visits, and hospitalizations. Results: The elderly accounted for 8.1% (N 725) and 11.6% (N 1749) of incident Crohn's disease (CD) and ulcerative colitis (UC), respectively. They were less likely than young adults to have any IBD-specific gastroenterology visit in the first year after diagnosis (CD, 63% versus 71%, P <0.001; UC, 63% versus 69%, P <0.001). They less frequently received continuous gastroenterology care (CD, 36% versus 46%, P <0.001; UC, 33% versus 43%, P <0.001). Elderly patients with IBD were less likely than young adults to require an IBD-specific emergency department visit in the first year (CD, 8.8% versus 18.5%, P <0.001; UC, 7.8% versus 11.6%, P <0.001). Similarly, elderly patients with CD exhibited lower hospitalization rates (incidence rate ratio, 0.62; 95% confidence interval, 0.59-0.65). Hospitalization rates were modestly higher among those elderly patients with UC compared with young adults during the first year (incidence rate ratio, 1.14; 95% confidence interval: 1.02-1.28), but this association reversed thereafter (incidence rate ratio, 0.64; 95% confidence interval: 0.57-0.71). Conclusions: Elderly patients with IBD exhibited lower IBD-specific health care utilization than young adults, which may reflect a multitude of factors including more benign disease and differential health care access.
AB - Background: There is an increasing burden of inflammatory bowel disease (IBD) among the elderly. We sought to characterize health care utilization of elderly onset IBD. Methods: We identified incident IBD cases in Ontario, Canada between 1999 and 2008 and categorized subjects by age at diagnosis as young (18-40 yr), middle-age (41-64 yr), and elderly (≥65 yr). We compared IBD-specific health utilization indicators, including outpatient visits, emergency department visits, and hospitalizations. Results: The elderly accounted for 8.1% (N 725) and 11.6% (N 1749) of incident Crohn's disease (CD) and ulcerative colitis (UC), respectively. They were less likely than young adults to have any IBD-specific gastroenterology visit in the first year after diagnosis (CD, 63% versus 71%, P <0.001; UC, 63% versus 69%, P <0.001). They less frequently received continuous gastroenterology care (CD, 36% versus 46%, P <0.001; UC, 33% versus 43%, P <0.001). Elderly patients with IBD were less likely than young adults to require an IBD-specific emergency department visit in the first year (CD, 8.8% versus 18.5%, P <0.001; UC, 7.8% versus 11.6%, P <0.001). Similarly, elderly patients with CD exhibited lower hospitalization rates (incidence rate ratio, 0.62; 95% confidence interval, 0.59-0.65). Hospitalization rates were modestly higher among those elderly patients with UC compared with young adults during the first year (incidence rate ratio, 1.14; 95% confidence interval: 1.02-1.28), but this association reversed thereafter (incidence rate ratio, 0.64; 95% confidence interval: 0.57-0.71). Conclusions: Elderly patients with IBD exhibited lower IBD-specific health care utilization than young adults, which may reflect a multitude of factors including more benign disease and differential health care access.
KW - Crohn's disease
KW - elderly
KW - inflammatory bowel disease
KW - ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=84925394181&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84925394181&partnerID=8YFLogxK
U2 - 10.1097/MIB.0000000000000306
DO - 10.1097/MIB.0000000000000306
M3 - Article
C2 - 25738376
AN - SCOPUS:84925394181
VL - 21
SP - 777
EP - 782
JO - Inflammatory Bowel Diseases
JF - Inflammatory Bowel Diseases
SN - 1078-0998
IS - 4
ER -