The Crohn's and Colitis Foundation of America Survey of Inflammatory Bowel Disease Patient Health Care Access

David T. Rubin, Lauren D. Feld, Sarah R. Goeppinger, Joel Margolese, Joel Rosh, Michele Rubin, Sandra Kim, Dylan M. Rodriquez, Laura Wingate

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Despite anecdotal information about unaffordable care for patients with inflammatory bowel disease (IBD), there are no data regarding access to health care resources and expert care for patients with IBD. Our study was designed to assess IBD patients' ability to access and use care, as well as the timeliness, affordability, and financial stressors related to care. Methods: We modified the Centers for Disease Control National Health Interview Survey for IBD. The resultant 59-question survey was electronically mailed to the entire Crohn's and Colitis Foundation of America (CCFA) mailing list. Three thousand six hundred eight adult U.S. respondents completed the survey. Statistical analysis was performed. Results: Respondents who had insurance coverage were 96.1%, but 66.3% reported health care-related financial worry. Of the 452 patients who tried to obtain new insurance coverage in the year prior, 60.1% (n = 270) reported difficulty finding sufficient coverage. We found that 25.4% (n = 897) of patients reported delays in medical care, and 48.0% (n = 431) of those respondents reported that the delay was due to cost concerns. Respondents who were denied coverage by an insurance company were 55.3%. Risk factors for emergency department utilization included Crohn's disease, younger age, female sex, lower income, non-White race, and steroid therapy. Conclusions: Our assessment of patient health care access suggests that many patients have health care-related financial worry and have forgone a variety of medical services because of cost, lack of prompt access to care, denial by insurance carriers, and worry over medical coverage. We also identify risk factors for emergency department utilization. These data inform additional studies and interventions to improve access for patients with IBD.

Original languageEnglish (US)
Pages (from-to)224-232
Number of pages9
JournalInflammatory bowel diseases
Volume23
Issue number2
DOIs
StatePublished - Feb 1 2017
Externally publishedYes

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Colitis
Inflammatory Bowel Diseases
Patient Care
Delivery of Health Care
Insurance Coverage
Hospital Emergency Service
Costs and Cost Analysis
Insurance Carriers
Health Services Accessibility
Health Resources
Centers for Disease Control and Prevention (U.S.)
Health Surveys
Crohn Disease
Surveys and Questionnaires
Steroids
Interviews

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Gastroenterology

Cite this

Rubin, David T. ; Feld, Lauren D. ; Goeppinger, Sarah R. ; Margolese, Joel ; Rosh, Joel ; Rubin, Michele ; Kim, Sandra ; Rodriquez, Dylan M. ; Wingate, Laura. / The Crohn's and Colitis Foundation of America Survey of Inflammatory Bowel Disease Patient Health Care Access. In: Inflammatory bowel diseases. 2017 ; Vol. 23, No. 2. pp. 224-232.
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abstract = "Background: Despite anecdotal information about unaffordable care for patients with inflammatory bowel disease (IBD), there are no data regarding access to health care resources and expert care for patients with IBD. Our study was designed to assess IBD patients' ability to access and use care, as well as the timeliness, affordability, and financial stressors related to care. Methods: We modified the Centers for Disease Control National Health Interview Survey for IBD. The resultant 59-question survey was electronically mailed to the entire Crohn's and Colitis Foundation of America (CCFA) mailing list. Three thousand six hundred eight adult U.S. respondents completed the survey. Statistical analysis was performed. Results: Respondents who had insurance coverage were 96.1{\%}, but 66.3{\%} reported health care-related financial worry. Of the 452 patients who tried to obtain new insurance coverage in the year prior, 60.1{\%} (n = 270) reported difficulty finding sufficient coverage. We found that 25.4{\%} (n = 897) of patients reported delays in medical care, and 48.0{\%} (n = 431) of those respondents reported that the delay was due to cost concerns. Respondents who were denied coverage by an insurance company were 55.3{\%}. Risk factors for emergency department utilization included Crohn's disease, younger age, female sex, lower income, non-White race, and steroid therapy. Conclusions: Our assessment of patient health care access suggests that many patients have health care-related financial worry and have forgone a variety of medical services because of cost, lack of prompt access to care, denial by insurance carriers, and worry over medical coverage. We also identify risk factors for emergency department utilization. These data inform additional studies and interventions to improve access for patients with IBD.",
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Rubin, DT, Feld, LD, Goeppinger, SR, Margolese, J, Rosh, J, Rubin, M, Kim, S, Rodriquez, DM & Wingate, L 2017, 'The Crohn's and Colitis Foundation of America Survey of Inflammatory Bowel Disease Patient Health Care Access', Inflammatory bowel diseases, vol. 23, no. 2, pp. 224-232. https://doi.org/10.1097/MIB.0000000000000994

The Crohn's and Colitis Foundation of America Survey of Inflammatory Bowel Disease Patient Health Care Access. / Rubin, David T.; Feld, Lauren D.; Goeppinger, Sarah R.; Margolese, Joel; Rosh, Joel; Rubin, Michele; Kim, Sandra; Rodriquez, Dylan M.; Wingate, Laura.

In: Inflammatory bowel diseases, Vol. 23, No. 2, 01.02.2017, p. 224-232.

Research output: Contribution to journalArticle

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T1 - The Crohn's and Colitis Foundation of America Survey of Inflammatory Bowel Disease Patient Health Care Access

AU - Rubin, David T.

AU - Feld, Lauren D.

AU - Goeppinger, Sarah R.

AU - Margolese, Joel

AU - Rosh, Joel

AU - Rubin, Michele

AU - Kim, Sandra

AU - Rodriquez, Dylan M.

AU - Wingate, Laura

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N2 - Background: Despite anecdotal information about unaffordable care for patients with inflammatory bowel disease (IBD), there are no data regarding access to health care resources and expert care for patients with IBD. Our study was designed to assess IBD patients' ability to access and use care, as well as the timeliness, affordability, and financial stressors related to care. Methods: We modified the Centers for Disease Control National Health Interview Survey for IBD. The resultant 59-question survey was electronically mailed to the entire Crohn's and Colitis Foundation of America (CCFA) mailing list. Three thousand six hundred eight adult U.S. respondents completed the survey. Statistical analysis was performed. Results: Respondents who had insurance coverage were 96.1%, but 66.3% reported health care-related financial worry. Of the 452 patients who tried to obtain new insurance coverage in the year prior, 60.1% (n = 270) reported difficulty finding sufficient coverage. We found that 25.4% (n = 897) of patients reported delays in medical care, and 48.0% (n = 431) of those respondents reported that the delay was due to cost concerns. Respondents who were denied coverage by an insurance company were 55.3%. Risk factors for emergency department utilization included Crohn's disease, younger age, female sex, lower income, non-White race, and steroid therapy. Conclusions: Our assessment of patient health care access suggests that many patients have health care-related financial worry and have forgone a variety of medical services because of cost, lack of prompt access to care, denial by insurance carriers, and worry over medical coverage. We also identify risk factors for emergency department utilization. These data inform additional studies and interventions to improve access for patients with IBD.

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