Ensuring Fair Access to Care for Inflammatory Bowel Disease: Obstacles, Approaches, and Future Perspectives
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By
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Johan Burisch
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Rupa Banerjee
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Gillian Watermeyer
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February 10, 2026
Clinical Scorecard: Ensuring Fair Access to Care for Inflammatory Bowel Disease: Obstacles, Approaches, and Future Perspectives
At a Glance
| Category | Detail |
|---|---|
| Condition | Inflammatory Bowel Disease (IBD), including Crohn’s disease and ulcerative colitis |
| Key Mechanisms | Rising global incidence with disparities in access due to geographic, socioeconomic, racial, and structural factors affecting diagnosis, treatment, and outcomes |
| Target Population | Global IBD patients, with emphasis on those in low- and middle-income countries, rural areas, disadvantaged socioeconomic groups, and ethnic/racial minorities |
| Care Setting | Multidisciplinary lifelong care settings including specialist clinics, hospitals, and community-based care with integration of telemedicine and digital health |
Key Highlights
- IBD prevalence is increasing globally, especially in newly industrialized regions, creating new challenges for health systems.
- Significant disparities exist in access to specialist care, diagnostics, and advanced therapies between high-income countries and LMICs, and within countries between urban and rural populations.
- Equitable care requires addressing social determinants of health, expanding capacity, leveraging cost-effective innovations, and fostering patient and community involvement.
Guideline-Based Recommendations
Diagnosis
- Expand diagnostic capacity including endoscopy and cross-sectional imaging in underserved regions.
- Use cost-effective diagnostic innovations such as intestinal ultrasound and telemedicine to improve access.
- Increase training and awareness to reduce diagnostic delays and stigma.
Management
- Implement multidisciplinary care teams including gastroenterologists, IBD nurses, and allied health specialists.
- Ensure equitable access to advanced therapies including biologics, especially for disadvantaged and minority populations.
- Embed equity principles into value-based care models and reimbursement policies.
Monitoring & Follow-up
- Utilize digital health tools and telemedicine to enhance ongoing monitoring while preventing digital exclusion.
- Apply artificial intelligence to support fair resource allocation and personalized care.
- Monitor disparities in healthcare utilization and outcomes to guide targeted interventions.
Risks
- Financial barriers leading to delayed or suboptimal treatment.
- Geographic isolation causing limited specialist access and increased emergency care reliance.
- Underrepresentation of minorities in clinical trials reducing evidence applicability.
- Fragmented care pathways and shortages of specialized staff worsening disparities.
Patient & Prescribing Data
IBD patients globally, with noted disparities in biologic therapy use among ethnic/racial minorities and low socioeconomic groups
Disadvantaged groups are less likely to receive biologics and experience delayed initiation of effective therapies, contributing to worse outcomes.
Clinical Best Practices
- Address social determinants of health through policy reforms and secure reimbursement mechanisms.
- Expand healthcare infrastructure and specialist workforce in LMICs and rural areas.
- Leverage telemedicine and digital innovations to improve access and continuity of care.
- Promote cultural competence and patient engagement to reduce stigma and improve adherence.
- Foster global partnerships to build capacity and share best practices.
References
- Global burden and epidemiology of IBD
- Healthcare disparities in IBD
- Use of telemedicine and innovations in IBD care
Based on findings from:
Equitable access to inflammatory bowel disease care: challenges, strategies, and future directions
Johan Burisch, Rupa Banerjee, Gillian Watermeyer. Journal Of Crohn's And Colitis, 2026.
https://academic.oup.com/ecco-jcc/article/20/Supplement_2/ii11/8489897
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