Systematic Review: The Impact of Geographic Location and Socioeconomic Status on Healthcare Utilisation and Clinical Outcomes in Patients With Inflammatory Bowel Disease (IBD) in the Developed World

ABSTRACT Background Inflammatory bowel diseases (IBD) are a group of chronic inflammatory conditions affecting the gastrointestinal tract, which requires life‐long management. Healthcare inequalities in IBD are a key factor influencing disease outcomes. Aim This review aimed to describe the impact of geographical location (urban vs. rural) and socioeconomic status (SES) on IBD healthcare utilisation and clinical outcomes. Methods A systematic review was conducted analysing quantitative studies from developed countries from 3 databases (PubMed, EMBASE and Cochrane library), published between January 1st 2000 and January 1st 2024. Healthcare utilisation outcomes were summarised by surgical rates, medication utilisation, outpatient gastroenterology care, emergency room visits and hospitalisation rates. Clinical outcomes were summarised by mortality rates, IBD‐related complication and patient reported disease activity. Results Twenty‐nine studies met the inclusion criteria for this review. Patients from rural areas had reduced access to specialist IBD care and more frequent emergency room presentations, yet similar rates of hospital admissions, medication use, and clinical outcomes compared to urban patients. Socioeconomic status influenced both surgical and hospitalisation outcomes. Patients with lower SES had higher rates of IBD‐related hospitalisations and increased inpatient mortality. They were also less likely to undergo colectomy for ulcerative colitis or resective surgery for Crohn's disease. Discussion This study, which is focussed on developed countries, highlights how geographical location and socioeconomic factors affect IBD healthcare use and outcomes. As IBD prevalence rises and disease complexity grows, delivering cost‐effective, equitable and high‐quality care to all patients is becoming an increasing challenge for healthcare systems worldwide.