Health Services Utilization and Specialist Care in Pediatric Inflammatory Bowel Disease: A Multiprovince Population-Based Cohort Study.

Autor:	Kuenzig ME; SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada.; Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada., Bitton A; Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, QC, Canada., Carroll MW; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada., Otley AR; Department of Pediatrics, Dalhousie University, Halifax, NS, Canada., Singh H; University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada.; Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.; Research Institute at CancerCare Manitoba, Winnipeg, MB, Canada., Kaplan GG; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada., Stukel TA; ICES, Toronto, ON, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada., Mack DR; CHEO Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, CHEO, Ottawa, ON, Canada.; CHEO Research Institute, Ottawa, ON, Canada.; Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada., Jacobson K; Department of Pediatrics, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada., Griffiths AM; SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada.; Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.; Department of Paediatrics, University of Toronto, Toronto, ON, Canada., El-Matary W; Department of Pediatrics, University of Manitoba, Winnipeg, MB, Canada., Targownik LE; Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Department of Medicine, University of Toronto, Toronto, ON, Canada., Nguyen GC; ICES, Toronto, ON, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.; Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Department of Medicine, University of Toronto, Toronto, ON, Canada., Jones JL; Department of Medicine, Dalhousie University, Halifax, NS, Canada., Murthy SK; Ottawa Hospital Research Institute, Ottawa, ON, Canada.; Department of Medicine, University of Ottawa, Ottawa, ON, Canada.; Division of Gastroenterology, Ottawa Hospital IBD Centre, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada., Bernstein CN; University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada.; Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada., Lix LM; Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada., Peña-Sánchez JN; Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada., Dummer TJB; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada., Spruin S; ICES, Toronto, ON, Canada.; Ottawa Hospital Research Institute, Ottawa, ON, Canada., Fung SG; CHEO Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, CHEO, Ottawa, ON, Canada.; CHEO Research Institute, Ottawa, ON, Canada., Nugent Z; University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada., Coward S; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada., Cui Y; Department of Medicine, Dalhousie University, Halifax, NS, Canada., Coulombe J; Department of Mathematics and Statistics, Université de Montréal, Montréal, QC, Canada., Filliter C; Lady Davis Institute of Medical Research, Jewish General Hospital, Montreal, QC, Canada., Benchimol EI; SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada.; Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.; ICES, Toronto, ON, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.; Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
Jazyk:	angličtina
Zdroj:	Inflammatory bowel diseases [Inflamm Bowel Dis] 2024 Feb 16. Date of Electronic Publication: 2024 Feb 16.
DOI:	10.1093/ibd/izae010
Abstrakt:	Background: Patterns of health services utilization among children with inflammatory bowel disease (IBD) are important to understand as the number of children with IBD continues to increase. We compared health services utilization and surgery among children diagnosed <10 years of age (Paris classification: A1a) and between 10 and <16 years of age (A1b). Methods: Incident cases of IBD diagnosed <16 years of age were identified using validated algorithms from deterministically linked health administrative data in 5 Canadian provinces (Alberta, Manitoba, Nova Scotia, Ontario, Quebec) to conduct a retrospective cohort study. We compared the frequency of IBD-specific outpatient visits, emergency department visits, and hospitalizations across age groups (A1a vs A1b [reference]) using negative binomial regression. The risk of surgery was compared across age groups using Cox proportional hazards models. Models were adjusted for sex, rural/urban residence location, and mean neighborhood income quintile. Province-specific estimates were pooled using random-effects meta-analysis. Results: Among the 1165 (65.7% Crohn's) children with IBD included in our study, there were no age differences in the frequency of hospitalizations (rate ratio [RR], 0.88; 95% confidence interval [CI], 0.74-1.06) or outpatient visits (RR, 0.95; 95% CI, 0.78-1.16). A1a children had fewer emergency department visits (RR, 0.70; 95% CI, 0.50-0.97) and were less likely to require a Crohn's-related surgery (hazard ratio, 0.49; 95% CI, 0.26-0.92). The risk of colectomy was similar among children with ulcerative colitis in both age groups (hazard ratio, 0.71; 95% CI, 0.49-1.01). Conclusions: Patterns of health services utilization are generally similar when comparing children diagnosed across age groups. (© 2024 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation.)
Databáze:	MEDLINE
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