Health Care Utilization in Elderly Onset Inflammatory Bowel Disease: A Population-based Study

Geoffrey C. Nguyen, Lisa Sheng, Eric I. Benchimol

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)777-782
Number of pages6
JournalInflammatory Bowel Diseases
Volume21
Issue number4
DOIs
Publication statusPublished - Mar 6 2015
Externally publishedYes

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Keywords

  • Crohn's disease
  • elderly
  • inflammatory bowel disease
  • ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy
  • Medicine(all)

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