S1925 Burden of Inflammatory Bowel Disease in Hispanic Patients: A Nationwide Analysis of Complications, Insurance Status, and Healthcare Utilization

Introduction: Although Hispanic individuals represent a growing proportion of inflammatory bowel disease (IBD) patients in the United States, data on their disease complications and access to care remain limited. This study examines IBD complications, insurance status, and healthcare utilization among hospitalized Hispanic adults with Crohn’s disease (CD) and ulcerative colitis (UC). Methods: We conducted a retrospective observational study using the Nationwide Inpatient Sample (2016–2021) to identify adult hospitalizations with a CD or UC diagnosis. Hispanic ethnicity was self-reported. Outcomes included prevalence and adjusted odds ratios (aORs) for IBD complications (anal abscesses, intestinal obstruction, rectal bleeding, fissure/fistula). Multivariable logistic regression adjusted for demographics, comorbidities, insurance, and hospital characteristics. Secondary outcomes included insurance type, length of stay, total hospital charges, and income quartile. Results: The study included 63,295 Hispanic patients with CD and 61,555 with UC. Compared to White patients, Hispanic patients were hospitalized at significantly younger ages (CD: 43.99 ± 19.39 vs 53.35 ± 19.36 years; UC: 45.49 ± 20.99 vs 57.80 ± 20.34 years; P < 0.001). They were more likely to fall into the lowest income quartile (CD: 31.3% vs 22.2%; UC: 30.8% vs 18.9%) and more frequently relied on Medicaid (CD: 29.6% vs 13.7%; UC: 29.4% vs 9.6%). Mean hospital stay was slightly longer for Hispanic patients (CD: 5.73 ± 7.45 vs 5.21 ± 6.36 days; UC: 5.73 ± 7.45 vs 5.63 ± 6.79 days), and total hospital charges were also higher (CD: $74,465.36 ± 128,699.66 vs $59,905.22 ± 97,051.24; UC: $81,123.00 ± 126,146.58 vs $69,304.65 ± 118,860.66). Hispanic patients with CD had significantly higher odds of rectal bleeding (aOR 1.28, 95% CI 1.21–1.35) and anal abscess (aOR 1.03, 95% CI 0.99–1.07), and lower odds of intestinal obstruction (aOR 0.88, 95% CI 0.86–0.91) compared to White patients. In UC, Hispanic patients also had elevated odds of rectal bleeding (aOR 1.23, 95% CI 1.21–1.27) and anal abscess (aOR 1.24, 95% CI 1.14–1.35). Conclusion: We observed that Hispanic patients with IBD experience higher rates of rectal bleeding and perianal complications, along with significant socioeconomic barriers, including greater reliance on Medicaid and lower household income. These disparities may contribute to delayed diagnosis and limited access to specialty care. Enhancing early intervention, insurance coverage, and access to advanced therapies is essential to improve outcomes.