Distance to Specialist Care and Disease Outcomes in Inflammatory Bowel Disease

Inflammatory Bowel Diseases
Nienke Z BorrenAshwin N Ananthakrishnan

Abstract

Optimal treatment of inflammatory bowel disease (IBD) requires specialized health care. Patients frequently travel long distances to obtain care for IBD, which may hinder regular care and affect outcomes adversely. This study included patients with established Crohn's disease or ulcerative colitis receiving care at a single referral center between January 2005 and August 2016. Distance to our health care center from the zip code of residence was determined for each patient and classified into quartiles. Our primary outcome was need for IBD-related surgery with secondary outcomes being need for biological and immunomodulator therapy. Logistic regression models adjusting for relevant covariates examined the independent association between travel distance and patient outcomes. Our study included 2136 patients with IBD (1197 Crohn's disease, 939 ulcerative colitis), among which just over half were women (52%), and the mean age was 41 years. The mean distance from our hospital was 2.5, 8.8, 22.0, and 50.8 miles for the first (most proximal) through fourth (most distant), respectively. We observed a statistically significant and meaningful higher risk among patients in the most distant quartile in the need for immunomodulator use (OR...Continue Reading

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Citations

Nov 18, 2017·Journal of Crohn's & Colitis·Nienke Z BorrenAshwin N Ananthakrishnan
May 17, 2019·Inflammatory Bowel Diseases·Frank I ScottCaren A Heller
Oct 12, 2021·Digestive Diseases and Sciences·Fang XuKurt J Greenlund

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