Emergency department utilisation for inflammatory bowel disease in the United States from 2006 to 2014
| Autor: | Vikram Rangan, Neil Sengupta, Anthony Lembo, Thomas Sommers, Julia Zubiago, Judy Nee, Sarah N. Flier, Prashant Singh, Michael P. Jones, William Hirsch, Adam S. Cheifetz, Johanna Iturrino, Andrea Bollom, Alan C. Moss, Sarah Ballou |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Tobacco use Adolescent Databases Factual Disease Inflammatory bowel disease 03 medical and health sciences Young Adult 0302 clinical medicine Patient Admission Crohn Disease Internal medicine medicine Humans Pharmacology (medical) Young adult Child Aged Aged 80 and over Hepatology business.industry Gastroenterology Infant Emergency department Middle Aged medicine.disease Inflammatory Bowel Diseases Ulcerative colitis United States Hospitalization Quartile 030220 oncology & carcinogenesis Child Preschool 030211 gastroenterology & hepatology Colitis Ulcerative Female business Emergency Service Hospital Medicaid |
| Zdroj: | Alimentary pharmacologytherapeutics. 47(7) |
| ISSN: | 1365-2036 |
| Popis: | Background Despite advances in treatment, patients with inflammatory bowel disease (IBD) frequently require emergency department (ED) visits and hospitalisations. Aims To analyse trends in ED visits and subsequent hospitalisations for IBD in the United States (US). Methods Data were analysed from the Nationwide Emergency Department Sample (NEDS) years 2006-2014. The NEDS is the largest all-payer ED database in the US, weighted to represent 135 million visits/year. IBD was identified using ICD-9 codes for Crohn's disease (CD) or ulcerative colitis (UC). Surgeries were identified using procedure codes. Results The frequency of IBD-ED visits increased 51.8%, from 90 846 visits in 2006 to 137 946 in 2014, which was statistically significant in linear regression. For comparison, all-case ED use between 2006 and 2014 increased 14.8%. In-patient hospitalisations from the ED decreased 12.1% for IBD (from 64.7% rate of hospitalisation from the ED in 2006 to 52.6% in 2014), with a UC:CD ratio of 1.2:1 in 2006 and 1.3:1 in 2014. Chi-square analysis revealed that this was a significant decrease. Surgery rates also showed a statistically significant decrease. The mean ED charge per patient rose 102.5% and the aggregate national cost of IBD-ED visits increased 207.5%. CD accounted for over twice as many visits as UC in both years. UC, age, male gender, highest income quartile, private insurance, Medicaid/Medicare, and tobacco use were associated with in-patient admissions. Conclusions The number of ED visits due to IBD and associated charges have continued to rise, while the rates of in-patient hospitalisations referred from the ED and surgeries have decreased. |
| Databáze: | OpenAIRE |
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