Health Care Utilization in Elderly Onset Inflammatory Bowel Disease
Bibliographic record
Abstract
BACKGROUND: There is an increasing burden of inflammatory bowel disease (IBD) among the elderly. We sought to characterize health care utilization of elderly onset IBD. METHODS: We identified incident IBD cases in Ontario, Canada between 1999 and 2008 and categorized subjects by age at diagnosis as young (18-40 yr), middle-age (41-64 yr), and elderly (≥65 yr). We compared IBD-specific health utilization indicators, including outpatient visits, emergency department visits, and hospitalizations. RESULTS: The elderly accounted for 8.1% (N = 725) and 11.6% (N = 1749) of incident Crohn's disease (CD) and ulcerative colitis (UC), respectively. They were less likely than young adults to have any IBD-specific gastroenterology visit in the first year after diagnosis (CD, 63% versus 71%, P < 0.001; UC, 63% versus 69%, P < 0.001). They less frequently received continuous gastroenterology care (CD, 36% versus 46%, P < 0.001; UC, 33% versus 43%, P < 0.001). Elderly patients with IBD were less likely than young adults to require an IBD-specific emergency department visit in the first year (CD, 8.8% versus 18.5%, P < 0.001; UC, 7.8% versus 11.6%, P < 0.001). Similarly, elderly patients with CD exhibited lower hospitalization rates (incidence rate ratio, 0.62; 95% confidence interval, 0.59-0.65). Hospitalization rates were modestly higher among those elderly patients with UC compared with young adults during the first year (incidence rate ratio, 1.14; 95% confidence interval: 1.02-1.28), but this association reversed thereafter (incidence rate ratio, 0.64; 95% confidence interval: 0.57-0.71). CONCLUSIONS: Elderly patients with IBD exhibited lower IBD-specific health care utilization than young adults, which may reflect a multitude of factors including more benign disease and differential health care access.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".