National 30-Day Readmission Trends in IBD 2014–2020—Are We Aiming for Improvement?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design and Data Sources
2.2. Study Population
2.3. Statistical Analysis and Outcome Measures
3. Results
3.1. CD Readmissions
3.2. UC Readmissions
3.3. Exploratory Analysis—Treated vs. Untreated IBD Patients
3.4. Hospitalization Cost Analysis
4. Discussion
4.1. Biodemographic Characteristics and Hospitalization Trends in Crohn’s Disease Admissions
4.2. Crohn’s Disease Specific Readmission (Only Emergency Hospitalizations)
4.3. Biodemographic Characteristics and Hospitalization Trends for Ulcerative Colitis Disease Admissions
5. Strengths and Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Year | ||||||
---|---|---|---|---|---|---|---|
2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | |
Number of emergency 30-day readmissions | 24 | 34 | 27 | 32 | 29 | 25 | 23 |
Age (mean ± SD, years) | 39.7 ± 18.9 | 42.9 ± 15.9 | 46.1 ± 22.0 | 44.6 ± 20.9 | 43.7 ± 21.1 | 48.6 ± 23.2 | 60.4 ± 22.6 |
Gender (%) | |||||||
Females | 45.8% | 55.9% | 66.7% | 56.3% | 55.2% | 52.0% | 73.9% |
Males | 54.2% | 44.1% | 33.3% | 43.8% | 44.8% | 48.0% | 26.1% |
Mean age females, years | 47.8 | 51.3 | 55.4 | 58.6 | 56.9 | 63.6 | 67.7 |
Mean age males, years | 32.9 | 32.2 | 27.6 | 26.5 | 27.5 | 32.4 | 39.8 |
Gender age gap, years | 14.9 | 19.1 | 27.8 | 32.1 | 29.4 | 31.2 | 27.9 |
Hospital type | |||||||
City | 8% | 26% | 33% | 38% | 31% | 24% | 26% |
Regional | 4% | 12% | 15% | 22% | 24% | 40% | 26% |
University | 88% | 62% | 52% | 41% | 45% | 36% | 48% |
Hospitalization discharge diagnosis | |||||||
K | 78.3% | 78.6% | 92.3% | 75.0% | 79.3% | 76.0% | 73.9% |
A | 4.3% | 14.3% | 3.8% | 9.4% | 0.0% | 8.0% | 8.7% |
M | 17.4% | 7.1% | 3.8% | 6.3% | 13.8% | 8.0% | 17.4% |
C | 0.0% | 0.0% | 0.0% | 9.4% | 6.9% | 8.0% | 0.0% |
Average LOS, days | |||||||
City | 11.0 | 5.4 | 11.0 | 7.9 | 6.8 | 7.8 | 5.4 |
Regional | 5.0 | 8.3 | 5.0 | 20.8 | 6.0 | 10.8 | 14.7 |
University | 5.2 | 11.5 | 8.6 | 21.7 | 14.6 | 5.0 | 10.2 |
Total in-hospital stay related to emergency 30-day readmission, days | 104 | 258 | 196 | 379 | 293 | 174 | 163 |
Number of surgeries | 1 | 4 | 1 | 1 | 1 | 1 | 1 |
Variable | Year | ||||||
---|---|---|---|---|---|---|---|
2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | |
Number of emergency 30-day readmissions | 54 | 52 | 79 | 72 | 102 | 93 | 63 |
Age (mean ± SD, years) | 61.0 ± 18.9 | 57.2 ± 19.3 | 53.5 ± 20.5 | 56.7 ± 19.5 | 55.8 ± 19.6 | 59.6 ± 15.5 | 62.0 ± 16.9 |
Gender (%) | |||||||
Females | 77.8% | 63.5% | 67.1% | 45.8% | 47.1% | 54.8% | 57.1% |
Males | 22.2% | 36.5% | 32.9% | 54.2% | 52.9% | 45.2% | 42.9% |
Mean age females, years | 62.0 | 61.1 | 56.8 | 51.8 | 59.3 | 62.6 | 67.1 |
Mean age males, years | 57.6 | 50.5 | 46.8 | 60.9 | 52.7 | 55.8 | 55.1 |
Gender age gap, years | 4.4 | 10.6 | 10 | −9.1 | 6.6 | 6.8 | 12 |
Hospital type | |||||||
City | 29.6% | 36.5% | 25.3% | 37.5% | 37.3% | 45.2% | 54.0% |
Regional | 25.9% | 15.4% | 22.8% | 23.6% | 22.5% | 14.0% | 14.3% |
University | 44.4% | 48.1% | 51.9% | 38.9% | 40.2% | 40.9% | 31.7% |
Hospitalization discharge diagnosis | |||||||
K | 60.4% | 54.9% | 61.5% | 59.7% | 60.8% | 59.3% | 59.0% |
A | 9.4% | 11.8% | 5.1% | 8.3% | 7.8% | 9.9% | 6.6% |
M | 26.4% | 23.5% | 25.6% | 27.8% | 26.5% | 26.4% | 29.5% |
C | 3.8% | 9.8% | 7.7% | 4.2% | 4.9% | 4.4% | 4.9% |
Average LOS, days | |||||||
City | 9.1 | 9.7 | 5.5 | 5.3 | 6.4 | 7.3 | 8.5 |
Regional | 7.8 | 5.8 | 9.0 | 12.5 | 8.1 | 7.6 | 6.3 |
University | 8.5 | 8.6 | 10.4 | 7.4 | 11.5 | 10.1 | 9.3 |
Total in-hospital stay related to emergency 30-day readmission, days | 336 | 345 | 639 | 456 | 709 | 522 | 362 |
Number of surgeries | 4 | 2 | 1 | 1 | 1 | 3 | 4 |
Variable | Year | p Trend 2014–2019 | p Trend 2014–2020 | ||||||
---|---|---|---|---|---|---|---|---|---|
2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | |||
Crohn’s disease | |||||||||
Number of admissions | 209 | 256 | 253 | 261 | 276 | 267 | 177 | >0.05 | >0.05 |
Number of CD-specific admissions | 98 | 104 | 118 | 114 | 115 | 134 | 63 | 0.013 | >0.05 |
CD-specific hospitalization rate per 100,000 person | 10.4 | 12.9 | 12.8 | 13.4 | 14.3 | 13.9 | 9.3 | >0.05 | >0.05 |
Number of emergency admissions | 142 | 143 | 139 | 145 | 131 | 133 | 109 | >0.05 | >0.05 |
Number of 30-day readmissions | 46 | 55 | 56 | 61 | 83 | 61 | 34 | >0.05 | >0.05 |
Number of emergency 30-day readmissions | 24 | 34 | 27 | 32 | 29 | 25 | 23 | >0.05 | >0.05 |
All-cause 30 day readmission rate, % | 11.5% | 13.3% | 10.7% | 12.3% | 10.5% | 9.4% | 13.0% | >0.05 | >0.05 |
Mean length of stay, days | 5.5 | 9.6 | 9.3 | 15.8 | 10.1 | 8.3 | 9.6 | >0.05 | >0.05 |
Ulcerative colitis | |||||||||
Number of admissions | 665 | 734 | 823 | 843 | 851 | 829 | 670 | >0.05 | p = 0.044 (2014–2018) p > 0.05 (2018–2020) |
Number of UC-specific admissions | 179 | 196 | 245 | 238 | 221 | 223 | 133 | >0.05 | >0.05 |
UC-specific hospitalization rate per 100,000 person | 33.2 | 37.0 | 41.8 | 43.2 | 44.0 | 43.2 | 35.1 | >0.05 | >0.05 |
Number of emergency admissions | 434 | 446 | 493 | 510 | 508 | 470 | 395 | >0.05 | p = 0.044 (2014–2018) p > 0.05 (2018–2020) |
Number of emergency 30-day readmissions | 54 | 52 | 79 | 72 | 102 | 93 | 63 | 0.018 | >0.05 |
All-cause 30day readmission rate, % | 14.3% | 12.9% | 17.3% | 16.4% | 18.3% | 16.2% | 13.0% | >0.05 | >0.05 |
IBD-specific emergency 30-day readmission | 7 | 12 | 26 | 24 | 24 | 20 | 11 | >0.05 | >0.05 |
IBD-specific 30-day readmission proportion, % | 24.2% | 26.3% | 32.4% | 34.8% | 19.2% | 21.6% | 14.9% | >0.05 | >0.05 |
Mean length of stay, days | 8.4 | 8.4 | 8.9 | 8.0 | 8.6 | 8.7 | 8.4 | >0.05 | >0.05 |
Variable | Year | ||||||
---|---|---|---|---|---|---|---|
2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | |
Crohn’s disease, total in-hospital days | |||||||
City | 25 | 52 | 76 | 79 | 54 | 56 | 68 |
Regional | 60 | 91 | 33 | 193 | 78 | 80 | 44 |
University | 617 | 676 | 706 | 598 | 768 | 687 | 446 |
IBD-related total hospital day costs, EUR | 107,783 | 124,361 | 123,388 | 129,630 | 137,116 | 124,947 | 83,417 |
Mean hospitalization day cost per patient, EUR | 1100 | 1196 | 1046 | 1137 | 1192 | 932 | 1324 |
Ulcerative colitis, total in-hospital days | |||||||
City | 185 | 231 | 264 | 311 | 294 | 307 | 227 |
Regional | 196 | 164 | 279 | 254 | 204 | 183 | 86 |
University | 889 | 912 | 1150 | 1179 | 1008 | 992 | 727 |
IBD-related total hospital day costs, EUR | 187,077 | 191,102 | 248,308 | 254,378 | 218,656 | 214,569 | 150,608 |
Mean hospitalization day cost per patient, EUR | 1045 | 975 | 1014 | 1069 | 989 | 962 | 1132 |
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Teterina, I.; Mirzajanova, V.; Mokricka, V.; Zolovs, M.; Šmits, D.; Pokrotnieks, J. National 30-Day Readmission Trends in IBD 2014–2020—Are We Aiming for Improvement? Medicina 2024, 60, 1310. https://doi.org/10.3390/medicina60081310
Teterina I, Mirzajanova V, Mokricka V, Zolovs M, Šmits D, Pokrotnieks J. National 30-Day Readmission Trends in IBD 2014–2020—Are We Aiming for Improvement? Medicina. 2024; 60(8):1310. https://doi.org/10.3390/medicina60081310
Chicago/Turabian StyleTeterina, Irēna, Veronika Mirzajanova, Viktorija Mokricka, Maksims Zolovs, Dins Šmits, and Juris Pokrotnieks. 2024. "National 30-Day Readmission Trends in IBD 2014–2020—Are We Aiming for Improvement?" Medicina 60, no. 8: 1310. https://doi.org/10.3390/medicina60081310