Jordan Ariel A, Bhat Shubha, Ali Tauseef, Brunskill Sarah R, Clusen Nancy A, Maltz Ross M, Moise Ced, Sun Xiaofan, Thomas Harry J, Ray Cassie, Harkins-Schwarz Mary, Ehrlich Orna G
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Department of Pharmacy, Cleveland Clinic Foundation, Cleveland, OH, USA.
Inflamm Bowel Dis. 2025 Jul 7;31(7):1819-1832. doi: 10.1093/ibd/izae237.
A prior survey disseminated in 2017 identified that healthcare access barriers exist and significantly affect patients with inflammatory bowel disease (IBD). We sought to identify, through an updated survey, the healthcare access barriers that patients continue to face, with a focus on socioeconomic factors and patient awareness of resources to navigate existing barriers.
A 52-question online survey evaluating (1) access to healthcare professionals, medications, and procedures; (2) associated financial challenges; and (3) patient awareness of education and advocacy tools to navigate IBD care barriers, was disseminated through multiple channels to IBD patients and their caregivers.
Of the 2281 completed responses, patients on advanced specialty medications, younger than 65 years of age, or on employer insurance experienced significantly greater issues with insurance barriers to accessing medications and coverage of medically necessary tests/treatments. Patients who live in areas of concentrated poverty were more likely to experience poor health outcomes when subjected to step therapy compared to patients who did not. Additionally, patients were more likely to experience one or more financial barriers or trade-offs if the patient used an advanced specialty medicine or lived in an area with concentrated poverty.
While there have been significant and numerous advancements in IBD treatments, patients with IBD continue to experience barriers to healthcare access and treatment and financial struggles. Ongoing awareness and advocacy efforts focused on healthcare system reform and related policies to further minimize care disparities and barriers remain vital.
2017年进行的一项前期调查发现，医疗保健获取障碍确实存在，并且对炎症性肠病（IBD）患者有显著影响。我们试图通过一项更新的调查，确定患者仍然面临的医疗保健获取障碍，重点关注社会经济因素以及患者对克服现有障碍的资源的认知。
一项包含52个问题的在线调查通过多种渠道分发给IBD患者及其护理人员，该调查评估（1）获得医疗专业人员、药物和治疗程序的情况；（2）相关的财务挑战；以及（3）患者对用于克服IBD护理障碍的教育和宣传工具的认知。
在2281份完成的回复中，使用高级专科药物、年龄小于65岁或参加雇主保险的患者在获取药物的保险障碍以及必要医疗检查/治疗的保险覆盖方面遇到的问题明显更多。与未处于贫困集中地区的患者相比，处于贫困集中地区的患者在接受阶梯治疗时更有可能出现健康状况不佳的情况。此外，如果患者使用高级专科药物或居住在贫困集中地区，他们更有可能遇到一个或多个财务障碍或权衡。
虽然IBD治疗已经取得了重大且众多的进展，但IBD患者在医疗保健获取和治疗方面仍然面临障碍以及财务困境。持续开展关注医疗保健系统改革和相关政策的宣传活动，以进一步减少护理差距和障碍，仍然至关重要。
