Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Youjie Huang, MD, DrPH and Regan Glover, MS. Bureau of Epidemiology, Florida Department of Health, 2585 Merchants Row Blvd, Room 320N, Tallahassee, FL 32312, 850-245-4407, youjie_huang@doh.state.fl.us

Objectives: Crohn's disease is a serious chronic disorder of the gastrointestinal tract. Estimates of the prevalence of Crohn's disease in North America vary from 26 to 199 per 100,000. Many studies used hospital based data to estimate prevalence. Little is known if the estimate is affected by type of health insurance. This study compares the prevalence of Crohn's disease between people with a private insurance and Medicaid in Florida. Methods: Crohn's disease is defined by ICD-9 procedure code of 555. Florida hospital discharge and ambulatory patient data in 1997-2004 were unduplicated and analyzed by patient's primary payer. The prevalence was calculated as the number of Crohn's disease patients per 100,000 patients seen in hospitals. Results: A total of 25,479,377 unduplicated records were analyzed. 11,845 inpatients and 22,005 ambulatory patients were diagnosed with Crohn's disease. Among Crohn's disease patients, 1,485 were Medicaid recipients, and 18,857 had a private insurance. The prevalence of Crohn's disease was lower among Medicaid recipients than patients with private insurance among both ambulatory patients (106.5 per 100,000 vs. 230.2 per 100,000) and among inpatients (55.1 per 100,000 vs. 139.5 per 100,000). More Medicaid recipients (50.1%) were treated as inpatients than patients with private insurance (26.8%). Conclusions: Lower prevalence of Crohn's disease and higher percent of patients hospitalized among Medicaid recipients suggests that Crohn's disease might be under-diagnosed among Medicaid recipients, particularly for those with mild disease. Efforts to estimate population-based prevalence need to take into account disparities in the prevalence due to access to health care.

Learning Objectives:

• 1) Recognize the importance of disparity in the prevalence of Crohn’s disease by type of patient's health insurance
• 2) Analyze hospital discharge and ambulatory patient data
• 3) Describe how access to health care could affect the estimate of prevalence of entire population.

Keywords: Access to Health Care, Medicaid

Related Web page: www.doh.state.fl.us/disease_ctrl/epi/Chronic_Disease/IBD/IBD.htm

Presenting author's disclosure statement:

Any relevant financial relationships? No