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  • Title: Health Care utilization in elderly onset inflammatory bowel disease: a population-based study.
    Author: Nguyen GC, Sheng L, Benchimol EI.
    Journal: Inflamm Bowel Dis; 2015 Apr; 21(4):777-82. PubMed ID: 25738376.
    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.
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