title: Differences in prevalence of inflammatory bowel disease in Puerto Rico between commercial and government-sponsored managed health care insured individuals.
abstract: BACKGROUND
  Evaluation of ethnic and racial patterns of Inflammatory Bowel Disease (IBD) has demonstrated a higher incidence of IBD in Jews, and lower rates in blacks and Hispanics when compared to whites. There is limited data describing incidence and prevalence among Hispanics, the fastest growing minority in the United States.
  
  
  METHODS
  To estimate the prevalence of IBD computerized records of all physicians billing and hospital discharges classified with ICD-9-CM IBD related codes were searched. Prevalence was estimated by age group, sex, and type of insurance (commercial versus government-sponsored managed care).
  
  
  RESULTS
  Of 1,248,993 insured individuals in 2005, 186 had a diagnosis of Crohn's disease and 291 of ulcerative colitis. The estimated prevalence per 100,000 was 14.9 for Crohn's disease, 23.3 for ulcerative colitis, and 38.2 cases for IBD. The most significant difference was found when comparing insurance type, with a total IBD prevalence rate of 61.75 cases among commercial versus 14.36 cases among government-sponsored insured.
  
  
  CONCLUSIONS
  The prevalence of IBD in this insured population in Puerto Rico places it among the highest described in a Hispanic population. Given the continued rise in prevalence of IBD and the limited studies describing the epidemiology of IBD in Hispanics, further studies which may provide important clues to the etiology of the disease as well as valuable information for appropriate health care planning are important.
authors.affiliation: Department of Medicine, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico. robertovendrell@yahoo.com
authors.forename: Roberto
authors.initials: R
authors.lastname: Vendrell
authors.forename: Heidi L
authors.initials: HL
authors.lastname: Venegas
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Pérez
authors.forename: Carlos
authors.initials: C
authors.lastname: Morell
authors.forename: Ruth V
authors.initials: RV
authors.lastname: Roman
authors.forename: Esther A
authors.initials: EA
authors.lastname: Torres
mesh_terms: D000328:Adult; D003132:Commerce; D005260:Female; D006076:Government; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D055815:Young Adult