{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:37:09Z","timestamp":1789141029877,"version":"build-2803163510"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100009490","name":"San Francisco General Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009490","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>With the onset of COVID-19, there were rapid changes in healthcare delivery as remote access became the norm. The aim of this study was to determine the impact of changes in healthcare delivery during the COVID-19 pandemic on patients with inflammatory bowel disease (IBD), in both well-resourced and vulnerable populations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Using a mixed methods, observational study design, patients receiving IBD care at a university or a safety-net hospital were identified by the electronic health record. Patient demographics, IBD history, and disease activity were acquired from the electronic health record. IBD-related outcomes were compared from the onset of the pandemic in the United States until December 2020 (COVID-19 pandemic year 1) and compared with outcomes in the previous year. A subset of participants provided their perspective on how changes in healthcare delivery and financial stability impacted their IBD through a standardized questionnaire and semi-structured interview.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Data from a total of 1449 participants were captured, 1324 at the tertiary care university hospital and 125 at the safety-net hospital. During COVID-19, there was a decrease in healthcare utilization at both sites. Race\/ethnicity and primary language were not associated with IBD-related hospitalizations or admissions. Patients that were employed and those with insurance had a higher number of IBD-related emergency department visits at both the university and safety-net hospitals (P = .03 and P = .01, respectively). Patients who did not speak English were more likely to report challenges using technology with telehealth and difficulty contacting IBD providers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>For IBD populations, during COVID-19, in both hospital settings, emergency department visits, hospitalizations, outpatient surgery, and clinic visits were reduced compared with the year prior. Patients with lower socioeconomic status and limited English proficiency reported facing more challenges with changes to healthcare delivery, healthcare access, and conveying changes in IBD activity. These results highlight the need for payors and providers to specifically attend to those populations most susceptible to these systemic and lasting changes in care delivery and promote greater equity in healthcare.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izad041","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T23:16:11Z","timestamp":1679440571000},"page":"29-37","source":"Crossref","is-referenced-by-count":5,"title":["Assessing the Impact of COVID-19 on IBD Outcomes Among Vulnerable Patient Populations in a Large Metropolitan Center"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3018-7024","authenticated-orcid":false,"given":"Florence-Damilola","family":"Odufalu","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Liver Diseases, Department of Medicine, University of Southern California , Los Angeles, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin L","family":"Sewell","sequence":"additional","affiliation":[{"name":"Gastroenterology Division, Zuckerberg-Chan San Francisco General Hospital and Trauma Center, University of California, San Francisco , San Francisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Rudrapatna","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco , San Francisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6116-3645","authenticated-orcid":false,"given":"Ma","family":"Somsouk","sequence":"additional","affiliation":[{"name":"Gastroenterology Division, Zuckerberg-Chan San Francisco General Hospital and Trauma Center, University of California, San Francisco , San Francisco, CA ,","place":["USA"]},{"name":"Center for Vulnerable Populations, University of California, San Francisco , San Francisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3067-8061","authenticated-orcid":false,"given":"Uma","family":"Mahadevan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco , San Francisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,21]]},"reference":[{"issue":"3","key":"2024102507560062900_CIT0001","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1056\/NEJMp2012910","article-title":"Racial health disparities and Covid-19 - caution and context","volume":"383","author":"Chowkwanyun","year":"2020","journal-title":"N Engl J Med."},{"issue":"9","key":"2024102507560062900_CIT0002","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1038\/s41575-020-0330-8","article-title":"COVID-19 and the other pandemic: populations made vulnerable by systemic inequity","volume":"17","author":"Gray","year":"2020","journal-title":"Nat Rev Gastroenterol Hepatol."},{"issue":"10","key":"2024102507560062900_CIT0003","doi-asserted-by":"crossref","first-page":"e0240151","DOI":"10.1371\/journal.pone.0240151","article-title":"Social determinants of COVID-19 mortality at the county level","volume":"15","author":"Fielding-Miller","year":"2020","journal-title":"PLoS One."},{"key":"2024102507560062900_CIT0004","volume-title":"Center","author":"COVID-19 telehealth coverage policies","year":"2020"},{"key":"2024102507560062900_CIT0005","volume-title":"Americas\u2019s Health Care Safety Net: Intact but Endangered","author":"Ein Lewin","year":"2000"},{"key":"2024102507560062900_CIT0006","author":"Dedoose Version 9.0.17, web application for managing, analyzing, and presenting qualitative and mixed method research data","year":"2021"},{"issue":"10","key":"2024102507560062900_CIT0007","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1001\/jamainternmed.2020.3288","article-title":"Trends in emergency department visits and hospital admissions in health care systems in 5 states in the first months of the COVID-19 pandemic in the US","volume":"180","author":"Jeffery","year":"2020","journal-title":"JAMA Intern Med"},{"issue":"25","key":"2024102507560062900_CIT0008","doi-asserted-by":"crossref","first-page":"7194","DOI":"10.1080\/14767058.2021.1946506","article-title":"Differences in obstetric healthcare utilization and delivery complications before and after the COVID-19 pandemic - 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