S3229 Outcomes of Inflammatory Bowel Disease in Teaching vs Non-Teaching Hospitals: A Nationwide Analysis

Abstract

INTRODUCTION: Inflammatory bowel disease (IBD) poses a significant health care burden, which from an economic perspective is particularly true for hospitalized IBD patients. The rising cost of hospitalized IBD patients is dictated by the severity, associated complications, and type of intervention used. Data regarding hospitalization outcomes in patients with IBD with respect to hospital teaching status is largely unknown. We attempt to investigate the impact of hospital teaching status on IBD hospitalization outcomes. METHODS: In this retrospective analysis we queried the 2016 and 2017 Nationwide Inpatient Sample (NIS) databases using the International Classification of Diseases 10th revision (ICD- 10) coding system. All adult patients with a principal diagnosis of IBD were included.We stratified the IBD group into Ulcerative colitis (UC), Crohn’s disease (CD), and complicated IBD. Our primary outcome was mortality. Statistical analysis was performed using STATA, version 16.0. RESULTS: Of the 189,950 adult patients with IBD, the majority were admitted to teaching hospitals (70.9%). There was no significant difference in mortality based upon hospital teaching status (aOR 1.18, P = 0.48); however, these patients had an increased mean length of stay (LOS) (adjusted coefficient: 0.82, P < 0.01), charges (adjusted coefficient: $8,732, P < 0.01), and costs ($2,871, P < 0.01). On subgroup analysis, patients with UC admitted to teaching hospitals had a significantly increased in-hospital mortality (aOR 2.11, P < 0.05), while those admitted with CD did not (aOR 0.80, P = 0.4). Among patients with complicated IBD, 73.17% were admitted to teaching hospitals, and no significant difference in in-hospital mortality was seen (aOR 1.06, P = 0.8). CONCLUSION: While outcome differences are likely related to multiple unaccounted factors, greater efforts should be placed to cost-effectively manage IBD patients at teaching institutions. Future studies are warranted to fully comprehend the variation of hospitalization outcomes in patients with IBD.