Racial disparity in healthcare utilization among patients with Irritable Bowel Syndrome: results from a multicenter cohort

Neurogastroenterol Motil. 2021 May;33(5):e14039. doi: 10.1111/nmo.14039. Epub 2020 Dec 1.

Abstract

Background: Racial disparity in healthcare is defined as differences in healthcare services received by racial groups not due to difference in needs or preferences. As irritable bowel syndrome (IBS) is highly correlated with social factors, healthcare disparities are important factors in the sociocultural model of IBS. We used healthcare utilization as a lens to examine potential racial disparities in IBS.

Methods: We retrospectively matched 3823 IBS minority patients who self-identified as "Hispanic," "Black," or "Asian" to white IBS controls and examined the number of patients with gastroenterology consults, gastroenterology procedures, and IBS-related Primary Care visits within each cohort from 2003 to 2017.

Key results: Minority IBS patients were less likely to receive a gastroenterology consult than white IBS controls. Both Black and Asian IBS patients were more likely to have an IBS-related Primary Care visit than white IBS controls. All 3 minority IBS cohorts received significantly more gastroenterology procedures compared to white IBS controls.

Conclusions & inferences: Minority IBS patients are more likely to receive gastroenterology procedures than white IBS patients. Further studies are needed to determine whether increased procedure likelihood in minority IBS patients represents a communication gap between minority patients and their providers or patient preference.

Keywords: healthcare utilization; patient-provider communication; psychosocial model of IBS; sociocultural factors; specialty care.

MeSH terms

  • Asian
  • Black or African American
  • Breath Tests / statistics & numerical data
  • Case-Control Studies
  • Cohort Studies
  • Colonoscopy / statistics & numerical data*
  • Communication
  • Endoscopy, Digestive System / statistics & numerical data*
  • Ethnic and Racial Minorities
  • Female
  • Gastroenterology
  • Healthcare Disparities / ethnology*
  • Hispanic or Latino
  • Humans
  • Irritable Bowel Syndrome*
  • Male
  • Middle Aged
  • Patient Preference
  • Physician-Patient Relations
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies
  • Sigmoidoscopy / statistics & numerical data
  • White People