دورية أكاديمية
أعرض في EDS

Inflammatory Bowel Disease in Appalachian Kentucky: An Investigation of Outcomes and Health Care Utilization.

التفاصيل البيبلوغرافية
العنوان: Inflammatory Bowel Disease in Appalachian Kentucky: An Investigation of Outcomes and Health Care Utilization.
المؤلفون: Rhudy CN; University of Kentucky Healthcare, Specialty Pharmacy and Infusion Services, Lexington, Kentucky, USA., Perry CL; University of Kentucky College of Medicine, Department of Medicine, Division of Digestive Diseases and Nutrition, Lexington, Kentucky, USA.; University of Kentucky Healthcare, Specialty Pharmacy and Infusion Services, Lexington, Kentucky, USA., Hawk GS; University of Kentucky, Dr. Bing Zhang Department of Statistics, Lexington, Kentucky, USA., Flomenhoft DR; University of Kentucky College of Medicine, Department of Medicine, Division of Digestive Diseases and Nutrition, Lexington, Kentucky, USA., Talbert JC; University of Kentucky College of Medicine, Division of Biomedical Informatics, Lexington, Kentucky, USA., Barrett TA; University of Kentucky College of Medicine, Department of Medicine, Division of Digestive Diseases and Nutrition, Lexington, Kentucky, USA.
المصدر: Inflammatory bowel diseases [Inflamm Bowel Dis] 2024 Mar 01; Vol. 30 (3), pp. 410-422.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Oxford University Press Country of Publication: England NLM ID: 9508162 Publication Model: Print Cited Medium: Internet ISSN: 1536-4844 (Electronic) Linking ISSN: 10780998 NLM ISO Abbreviation: Inflamm Bowel Dis Subsets: MEDLINE
أسماء مطبوعة: Publication: 2018- : [Oxford] : Oxford University Press
Original Publication: New York, NY : Raven Press, c1995-
مواضيع طبية MeSH: Inflammatory Bowel Diseases*/epidemiology , Inflammatory Bowel Diseases*/therapy , Colitis, Ulcerative*/epidemiology , Colitis, Ulcerative*/therapy , Crohn Disease*, Humans ; Child, Preschool ; Kentucky/epidemiology ; Patient Acceptance of Health Care
مستخلص: Background: Rural residence has been associated with a lower incidence of inflammatory bowel disease (IBD) but higher health care utilization and worse outcomes. Socioeconomic status is intrinsically tied to both IBD incidence and outcomes. Inflammatory bowel disease outcomes have not been investigated in Appalachia: a rural, economically distressed region rife with risk factors for both increased incidence and unfavorable outcomes.
Methods: Hospital inpatient discharge and outpatient services databases were utilized to assess outcomes in patients diagnosed with either Crohn's disease (CD) or ulcerative colitis (UC) in Kentucky. Encounters were classified by patient residence in Appalachian or non-Appalachian counties. Data were reported as crude and age-adjusted rates of visits per 100,000 population per year collected in 2016 to 2019. National inpatient discharge data from 2019, stratified by rural and urban classification codes, were utilized to compare Kentucky to national trends.
Results: Crude and age-adjusted rates of inpatient, emergency department and outpatient encounters were higher in the Appalachian cohort for all 4 years observed. Appalachian inpatient encounters are more frequently associated with a surgical procedure (Appalachian, 676, 24.7% vs non-Appalachian, 1408, 22.2%; P = .0091). In 2019, the Kentucky Appalachian cohort had significantly higher crude and age-adjusted rates of inpatient discharges for all IBD diagnoses compared with national rural and nonrural populations (crude 55.2; 95% CI, 50.9-59.5; age-adjusted 56.7; 95% CI, 52.1-61.3).
Conclusions: There is disproportionately higher IBD health care utilization in Appalachian Kentucky compared with all cohorts, including the national rural population. There is a need for aggressive investigation into root causes of these disparate outcomes and identification of barriers to appropriate IBD care.
(© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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معلومات مُعتمدة: UL1TR001998 United States TR NCATS NIH HHS; R21 DK118954 United States DK NIDDK NIH HHS; 2RO1 DK095662-10A1 United States DK NIDDK NIH HHS; TL1TR001997 United States NH NIH HHS; UL1 TR001998 United States TR NCATS NIH HHS; TL1 TR001997 United States TR NCATS NIH HHS
فهرسة مساهمة: Keywords: health care disparities; inflammatory bowel disease; outcomes and utilization
Local Abstract: [plain-language-summary] The Kentucky Appalachian IBD population experiences increased health care utilization, with increased rates of inpatient admissions, emergency department, and outpatient visits compared with non-Appalachian Kentuckians. Kentucky Appalachian rates of inpatient admissions are higher compared with national rates, controlling for rural residence.
تواريخ الأحداث: Date Created: 20230606 Date Completed: 20240304 Latest Revision: 20240607
رمز التحديث: 20240607
مُعرف محوري في PubMed: PMC10906357
DOI: 10.1093/ibd/izad096
PMID: 37280118
قاعدة البيانات: MEDLINE
الوصف
تدمد:1536-4844
DOI:10.1093/ibd/izad096