• Am J Manag Care · Oct 2019

    Inflammatory bowel disease readmissions are associated with utilization and comorbidity.

    • Shirley Cohen-Mekelburg, Russell Rosenblatt, Beth Wallace, Nicole Shen, Brett Fortune, Akbar K Waljee, Sameer Saini, Ellen Scherl, Robert Burakoff, and Mark Unruh.
    • Michigan Medicine, 3192 Taubman Center, 1500 E Medical Center Dr, SPC 2435, Ann Arbor, MI 48103. Email: shcohen@umich.edu.
    • Am J Manag Care. 2019 Oct 1; 25 (10): 474-481.

    ObjectivesHospital care accounts for up to one-third of the cost of inflammatory bowel disease (IBD) management. A select group of patients with IBD is responsible for a large proportion of this utilization, demonstrating the burden of frequent hospitalizations. We aim to better understand the burden of 30-day readmissions among patients with IBD using a national hospital database.Study DesignRetrospective cohort study of state-specific inpatient databases.MethodsThe State Inpatient Databases for New York and Florida were used to identify patients with IBD hospitalized between 2009 and 2013. The prevalence of 30-day IBD-specific readmission was determined. The association between 30-day readmission and visit outcomes, specifically length of stay and a composite of comorbid conditions (venous thromboembolism, pneumonia, sepsis, Clostridium difficile infection, enteral and parenteral nutrition, and blood transfusion), was analyzed using multivariable logistic regression.ResultsPatients with IBD accounted for 35,514 and 39,506 inpatient stays in New York and Florida, respectively. Of these stays, 13.7% to 16.2% resulted in a 30-day readmission. On multivariable analysis, 30-day readmissions were associated with a longer length of stay than index hospitalizations by 1.00 day (adjusted regression coefficient, 1.00; 95% CI, 0.73-1.26) and a higher likelihood of having a comorbid condition (adjusted odds ratio, 1.83; 95% CI, 1.68-1.99) in New York. Similar associations were confirmed in Florida.ConclusionsNearly 1 in 7 hospitalizations of patients with IBD lead to a 30-day readmission. These IBD-specific readmissions are associated with increased utilization and comorbidity. Patients at risk for readmission need to be targeted to improve outcomes and IBD care quality.

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