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Investigation of Geospatial Disparities in Chronic Pancreatitis Outcomes
Tamara F Kahan1, Marco Noriega2, Anabel Liyen-Cartelle1
1Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
Pancreas
|December 3, 2024
Summary
Patients in socially vulnerable areas with chronic pancreatitis (CP) experienced more flares but used less opioid pain relief. This suggests potential disparities in pain management for vulnerable populations with CP.
Area of Science:
- Gastroenterology
- Public Health
- Health Disparities
Background:
- Chronic pancreatitis (CP) is a debilitating fibro-inflammatory condition causing significant morbidity.
- Geospatial factors, such as social vulnerability, may influence CP patient outcomes.
- The Social Vulnerability Index (SVI) quantifies neighborhood vulnerability based on socioeconomic status, household composition, race/ethnicity, and housing type.
Purpose of the Study:
- To investigate the association between geospatial parameters, quantified by the SVI, and clinical outcomes in patients with chronic pancreatitis.
- To determine if neighborhood social vulnerability impacts CP disease course, complications, and healthcare utilization.
Main Methods:
- Retrospective analysis of 324 chronic pancreatitis patients at a dedicated pancreas center.
- Assessment of patient demographics, CP flares, complications, healthcare resource utilization, and opioid prescriptions.
- Regression analysis to correlate outcomes with SVI quartiles (I-IV, with IV being most vulnerable).
Main Results:
- Higher SVI quartiles showed trends towards greater reliance on government or no insurance.
- Patients in higher SVI quartiles experienced significantly more hospitalizations for CP flares.
- Reduced outpatient opioid use was observed in patients residing in more vulnerable neighborhoods, despite similar rates of pancreatic dysfunction and healthcare utilization across SVI quartiles.
Conclusions:
- Residence in highly vulnerable neighborhoods may be linked to more frequent CP flares and lower opioid utilization.
- These findings suggest potential inadequacies in pain management for vulnerable CP patients.
- Further prospective research is warranted to explore the impact of social determinants of health on CP management and outcomes.
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