HEALTH OUTCOMES AMONG PATIENTS WITH ULCERATIVE COLITIS

Abstract

Purpose: To assess the occurrence of health outcomes among patients with ulcerative colitis (UC) by age and sex, rates of medical encounters were compared between UC patients and a comparable population without any inflammatory bowel disease. Methods: The data source was medical claims of a health plan, which has over 7 million members within 25 states (Ingenix Lab/Rx Database™). Among members with at least two continuous years in the health plan, UC patients were identified by a medical claim with a diagnosis code of ICD-9-CM 556 in at least two ambulatory visits or one hospitalization. The control cohort, matched 4:1 on sex and year of birth, had no diagnoses of inflammatory bowel disease (ICD-9-CM 555.0 – 558.9). Three outcome measures were rates of ambulatory visits, hospitalizations, and hospitalizations for a surgical operation on the digestive system. Results: During 3.5 years of observation there were 12,061 UC patients, corresponding to a prevalence of 236 per 100,000 persons within the plan. The demographic profile of the UC population was 53% males and 47% females; 24% less than 35 years of age, 64% ages 35–64, and 12% age 65 and over. Among the UC population, an individual averaged 15 ambulatory visits per year. Of every 1,000 UC patients during a one year period, there were 202 hospitalizations, of which 57 included a gastrointestinal surgery. Among the non-UC population, an individual averaged 7 ambulatory visits per year. Of every 1,000 non-UC patients during a one year period, there were 63 hospitalizations, of which 7 included a gastrointestinal surgery. The rate ratios of medical outcomes between UC and non-UC patients were the most pronounced among younger males (< 35 years old) as shown in the table below.Table 1: Rate ratios for occurence of selected medical events between population with ulcerative colitis and population without IBD, by age and sex.Conclusions: The substantial increase in hospitalizations and subsequent surgeries of younger men with UC is a new finding. It presents a unique challenge to raising both disease awareness and treatment adoption in these patients and warrants further study.