Socioeconomic equality in initiation of biologic treatment in Danish patients with inflammatory bowel disease

Author:

Petersen Sofie Ronja,Fogh Rasmussen Nathalie,Overgaard Donskov Agnete,Thygesen Lau Caspar,Olsen Kim Rose,Juel Ahrenfeldt Linda,Andersen Vibeke

Abstract

Summary Background Low socioeconomic status is associated with disadvantages in health outcomes and delivery of medical care in patients with Inflammatory Bowel Disease (IBD). Inequality in the utilisation of biologic treatment is largely unexplored. Aim To explore the potential association of socioeconomic status and time to first biologic treatment in a population-based IBD cohort. Methods All 37,380 IBD incidences between 2000 and 2017 from the Danish National Patient Register were identified and linked to socioeconomic information including educational level, income and occupational status at diagnosis. Hazard ratios for receiving biologic treatment among socioeconomic groups were estimated using Cox proportional hazard regression. Results No difference in time between diagnosis and biologic treatment initiation was found comparing patients with upper secondary, vocational, or academic education to those with lower secondary education in patients with IBD. Patients with Crohn’s disease in the two highest income quartiles received biologic treatment earlier (HR 1.16; 95% CI: 1.04; 1.30 & HR 1.15; 95% CI: 1.03; 1.30). An elevated treatment rate was found for persons with “other” occupational status (unspecified source of income) compared to employed persons in patients with ulcerative colitis (HR 1.36; 95% CI: 1.11; 1.66), but not in patients with Crohn’s disease. Conclusion This study revealed equal initiation of biologic treatment among patients with IBD across different educational background, income and occupational status. However, results are limited to a setting with free universal healthcare coverage and treatment needs should be considered and addressed in future research.

Funder

Beckett-Fonden

Knud og Edith Eriksens Mindefond

University of Southern Denmark

Publisher

Springer Science and Business Media LLC

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