P2612 - The Impact of Social Determinants of Health on Ulcerative Colitis Outcomes

Julie Murone, DO, Scarlett Austin, DO, Divya Venkat, MD, Heitham Abdul-Baki, MD
Allegheny Health Network, Pittsburgh, PA

Introduction: Development of Ulcerative Colitis (UC) in an individual is a complex system that includes genetic factors, immune function, as well as the internal and external environment in which an individual lives. To better understand the effect of the external environment, we considered outcomes of UC patients as they related to the social determinants of health (SDOH). SDOH are the conditions in which people are born, live, and work. Ultimately, they reflect community resources and access to healthcare including transportation, social support and education.

Methods: A sample of patients were randomly selected from a database of UC patients within a tertiary care center, located in Pittsburgh, PA, who had a confirmed diagnosis of UC and were on biologic therapy. General demographics, insurer, and information about applications to disability were collected. Information relating to disease prognosis such as disease complications and indicators of poor disease outcomes were collected by reviewing frequency of prescriptions for steroids, UC therapies, and surgical interventions.

Results: A total of 249 patients (mean age 51.2 years old) were included in the study. 15 patients identified as non-white. A total of 70 patients in the study were enrolled in Medicare, Medicaid or both. 59 patients had applied for disability related to their UC. 44 patients underwent colectomy related to UC. A significant difference (p< 0.05) was determined between colectomy or resection frequency for UC in patients with Medicaid, Medicare, and patients who applied for disability when compared to patients who were not enrolled in these programs. When reviewing prescriptions for steroid usage, there was no significant difference between those enrolled in Medicaid and Medicare compared to commercial insurance. No significant difference was found between the number of UC regimens trialed for those on Medicaid or Medicare versus commercial insurance.

Discussion: Based on our data, there is a significant difference in individuals who received colectomy or resection due to their UC if they are enrolled in Medicaid, Medicare, or have applied for disability. It cannot be determined if the disability applications are related to SDOH or if they are due to an unrelated more difficult disease course. This distinction demonstrates a worse clinical outcome in a population that is likely already at a disadvantage. Recognizing the role of SDOH is an important step in the prevention of poor clinical outcomes in patients with UC.


Disclosures:


Julie Murone, DO, Scarlett Austin, DO, Divya Venkat, MD, Heitham Abdul-Baki, MD. P2612 - The Impact of Social Determinants of Health on Ulcerative Colitis Outcomes, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.