In December 2008, the journal Inflammatory Bowel Diseases published an article titled, "Hospitalizations for inflammatory bowel disease: Profile of the uninsured in the United States."
The introduction of the article includes several sobering points:
- More than 70% of CD patients and a third of UC patients may require IBD-related surgery over a lifetime.
- These hospitalizations account for at least half of direct costs attributable to IBD, which does not account for the indirect costs associated with disability and time away from work.
- IBD patients are more than twice as likely to be out of the labor force compared to the general population, which may leave them vulnerable to loss of health coverage.
- Uninsured IBD patients may be vulnerable to a vicious cycle of increased hospitalizations, chronic disability, and financial debt from health care costs.
The study found the following:
Time period: 1999 - 2005
IBD hospitalization rate for uninsured: 64% increase
IBD hospitalization rate for the insured: 21% increase
*General medical hospitalization rate for the uninsured: 5% net increase
(*Note: "Rates of uninsured and privately insured admissions among general medical patients fluctuated annually by less than 5% and demonstrated no consistent trends over the study period.")
The study found that the disparity is "driven by a higher preponderance of young adults between 21 and 40 years who are relatively more likely to be uninsured in the IBD population compared to the general population." The article points out that the disproportionately high IBD hospitalization rates will continue to increase, citing inability to pay for medical expenses such as expensive drugs. The authors conclude with the following:
Given the impact of being without health coverage, we need to develop measures to allow a safety net for those at greatest risk for being uninsured given the high costs associated with IBD care. It is young adults with IBD who are least likely to have the capital reserve to weather the financial stresses of an undulating and often unpredictable clinical course of their disease.