P830 Significant racial and ethnic disparities exist in health-care utilization in inflammatory bowel disease: a systematic review and meta-analysis

Chhibba, T.(1)*;Tandon, P.(1);Natt, N.(2);Brar, G.(3);Gurpreet, M.(4);Geoffrey, N.(1);

(1)University of Toronto, Gastroenterology, Toronto, Canada;(2)Northern Ontario School of Medicine, Internal Medicine, Thunder Bay, Canada;(3)University of Toronto, Internal Medicine, Toronto, Canada;(4)Western University, Gastroenterology, London, Canada;


The incidence of inflammatory bowel disease (IBD) is rising worldwide though it remains unknown how race and ethnicity mediate health-care utilization. We aimed to better define this relationship in this systematic review and meta-analysis.


We explored the impact of race or ethnicity on the likelihood of needing an IBD-related surgery, hospitalization, and emergency department (ED) visit. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated with I2 values reporting heterogeneity. Differences in IBD phenotype and treatment between racial and ethnic groups of IBD were reported.


Fifty-eight studies were included. Compared to White patients, Black patients were less likely to undergo a Crohn’s disease  (CD) (OR 0.69, 95% CI, 0.50-0.95, I2=68.0%) or ulcerative colitis (OR 0.58, 95% CI, 0.40-0.83, I2=85.0%) surgery, more likely to have an IBD-hospitalization (OR 1.54, 95% CI, 1.06-2.24, I2=77.0%), and more likely to visit the ED (OR 1.74, 95% CI, 1.32-2.30, I2=0%). There were no significant differences in disease behavior or biologic exposure between Black and White patients and between Hispanic and White patients (Table 1). Hispanic patients were less likely to undergo a CD surgery (OR 0.57, 95% CI, 0.48-0.68, I2=0%) but more likely to be hospitalized (OR 1.38, 95% CI, 1.01-1.88, I2=37.0%) compared to White patients. There were no differences in health-care utilization between White and Asian or South Asian patients with IBD.


There remain significant differences in health-care utilization amongst races and ethnicities in IBD. Future research is required to determine factors behind these differences to achieve equitable care for all persons living with IBD.