Young Adults with Inflammatory Bowel Disease in the US Experience Gaps in Healthcare Access and Financial Stress: Additional Findings from a Recent Survey by the Crohn's & Colitis Foundation.

Background: Young adults with chronic conditions are at increased risk for active disease and for poor adherence, resulting in increased emergency department utilization and hospitalizations. We aimed to evaluate whether young adults with inflammatory bowel disease (IBD) experienced more healthcare access challenges and financial distress compared to adults and pediatric patients. Methods: A survey developed by the Crohn's & Colitis Foundation was electronically disseminated to adults with IBD and caregivers across the United States to assess healthcare access and financial challenges. Analyses were completed to evaluate differences across patient age groups (caregivers on behalf of pediatric patients <18 years, young adults 18-25 years, and adults 26-64 years) using Chi square or Fisher's exact tests. Results: Of 1781 respondents (77% adult, 12.9% young adult, and 10.1% pediatric caregivers), there were no significant differences between groups in obtaining insurance approval and experiencing adverse health events due to treatment delays. However, young adults were more likely to experience step therapy mandates and less likely to know what questions to ask their insurer if experiencing coverage problems compared to adult and pediatric patients' caregivers. Additionally, young adult patients were more likely to take on an extra job or work more hours to afford their healthcare or insurance costs related to IBD. Conclusion: Additional analysis from the Crohn's & Colitis Foundation access assessment highlights the need for more resources and support in navigating healthcare access for young adult patients with IBD.