S718 Prolonged Impact of Pandemic Restrictions on Healthcare Utilization in Patients With IBD

Abstract

Introduction: The COVID-19 pandemic disrupted healthcare delivery due to local restrictions and public health precautions. Who was most impacted, and the duration of these impacts in patients with IBD has not been quantified to date. Methods: This is an analysis of retrospectively collected data in a large urban safety-net hospital. We identified a cohort of patients with IBD, and quantified their healthcare utilization (HU) during three distinct 90-day periods related to the COVID-19 pandemic;pre-restrictions, restriction period, and recovery period. Demographic data were collected for all patients. Health care utilization was determined by the number of IBD clinic visits (in-person and virtual), abdominal imaging scans, emergency department (ED) visits, hospital admissions, and IBD-related endoscopic procedures. Results: We identified and collected data on 311 patients were collected, during the three time periods. The demographics of this cohort were representative of our IBD population;mean age 46, 53% female, 35% Black, 44% federal or state insurance. Clinic visits declined by 60%, imaging by 50%, and endoscopy declined by 91% during the restriction period (Figure 1). Older age and Black race were significantly associated (p<0.05) with clinic absence during the restriction period. During the recovery period, healthcare utilization remained significantly reduced;clinic visits only improved by 14%, despite universal use of telemedicine (Figure 1). Neither ED visits nor hospitalizations increased in the recovery period. No demographic factor was associated with the resumption of clinic visits, ED, or endoscopy. Conclusion: Pandemic public health restrictions significantly reduced HU for patients with IBD, and these had not recovered within 90 days after the opening of restrictions. Age and race were associated with loss of follow-up during the restriction periods. No increase in ED or hospitalization was noted during the recovery period.