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 23 October 2017

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Predictors of hospital readmissions for ulcerative colitis in the USA

March's issue of the Inflammatory Bowel Diseases performs a national database study to identify predictors of hospital readmissions for ulcerative colitis.

News image

Reducing hospital readmissions has become a priority for health care throughout the United States to improve quality of care and decrease costs. 

It has been estimated that up to one-fifth of Medicare patients are readmitted within 30 days with an annual cost of $17.4 billion because of unplanned readmissions of which one-third may be preventable. 

Around 27% of hospital readmissions may be avoidable, although some estimates are as high as 79%. 

Decreasing readmissions is of importance to health care systems given financial disincentives and penalties around reimbursement for 30-day readmissions, and to patients by avoiding the direct and indirect burden and costs of hospitalizations.

It is estimated that at least 3 million people in the United States have inflammatory bowel disease (IBD) with around half having ulcerative colitis (UC).

Hospitalization rates for UC have increased recently with rates ranging from 8 to 12 per 100,000 per year
Inflammatory Bowel Diseases
Dr Ryan Ungaro and colleagues analyzed an all-payer, nationally representative database to describe unplanned 30-day readmissions to assess predictors of readmission among adult UC patients in the United States.

The team report that the incidence of IBD has been rising over time.

The research team found that the total direct and indirect costs of UC in the United States are estimated to be between $8 and $15 billion annually, of which hospitalizations account for up to one half.

Half of all UC patients have at least 1 hospitalization during their lifetime.

Despite significant advances in medical therapy, hospitalization rates for UC have not decreased and may have even increased recently with rates ranging from 8 to 12 per 100,000 per year.

In addition, the team noted that the number of hospitalization days is now considered an outcome measure for quality of care in IBD according to a set of IBD quality indicators developed by an expert panel.

Although hospitalizations are a significant driver of health care utilization among UC patients, relatively little is known about the epidemiology and risk factors for 30-day readmissions for UC in the United States. 

Dr Ungaro's team comments, "Most prior data on UC readmissions have been from single center experiences or other countries."

"We analyzed nationally representative database to describe unplanned 30-day readmissions to assess predictors of readmission among adult UC patients in the United States."

Inflamm Bowel Dis 2017: 23(3): 347–356
15 March 2017

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