S1533 Racial Disparities in Delayed Healthcare Among Individuals With and Without Inflammatory Bowel Disease: A MEPS-Based Analysis

Introduction: Delayed access to healthcare is a significant concern for patients with chronic diseases like inflammatory bowel disease (IBD). However, the intersection between race/ethnicity, IBD status, and care access is poorly understood. This study aimed to assess disparities in delayed healthcare in relation to IBD status and racial background. Methods: We analyzed data from the 2020 Medical Expenditure Panel Survey (MEPS), including the Full-Year Consolidated Data File and the Medical Conditions File. Adults with IBD were identified based on International Classification of Diseases-10 codes K50 (Crohn’s disease) and K51 (ulcerative colitis). The primary outcome was delayed care, recoded as a binary variable. A survey-weighted logistic regression model was used to estimate the association between race/ethnicity, IBD status, and delayed care. We then adjusted for potential confounders, including age, sex, insurance status, and poverty category. Results: In the unadjusted model, race, IBD, and their interaction were significantly associated with delayed care (P < 0.001). In the adjusted model, significant predictors of delayed care included age (older age associated with higher odds), female sex, and being uninsured. Race remained a significant predictor, with Black and Other race individuals experiencing higher odds of delayed care than White individuals, and Asian individuals experiencing significantly lower odds. Among individuals with IBD, Black and Hispanic patients had the highest adjusted predicted probabilities of delayed care (13.4% and 11.3%, respectively), while Asian and Other/Mixed race individuals had the lowest (0.5% and 0.4%). Conclusion: Racial disparities in delayed healthcare access persist among individuals with IBD, even after adjusting for sociodemographic confounders. Black and Hispanic patients with IBD remain at highest risk. Targeted efforts to reduce care barriers among vulnerable populations are needed to improve equitable access to healthcare.