Emergency department utilisation for inflammatory bowel disease in the United States from 2006 to 2014

S. Ballou*, W. Hirsch, P. Singh, V. Rangan, J. Nee, J. Iturrino, T. Sommers, J. Zubiago, N. Sengupta, A. Bollom, M. Jones, A. C. Moss, S. N. Flier, A. S. Cheifetz, A. Lembo

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)913-921
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume47
Issue number7
DOIs
Publication statusPublished - Apr 2018

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