Decreasing IBD Hospitalization Rates Suggest Increased Outpatient Management

Patients with inflammatory bowel disease (IBD) living in Canada demonstrated decreasing rates of hospitalization over the past 2 decades, suggesting increased outpatient care management for this condition, according to study findings published in Inflammatory Bowel Diseases.

Researchers conducted a population-based, administrative data, cohort study, obtaining data from health care databases on patients living with IBD in Alberta, Canada. They identified 37,413 patients with IBD — 44,284 with Crohn disease (CD), 22,860 with ulcerative colitis (UC), and 8,244 with unclassified IBD.

These 37,413 patients with IBD accounted for a total of 75,388 all-cause hospitalizations during this study’s time period. Of these 75,388 all-cause hospitalizations, 43,954 (58.3%) were classified as IBD-related hospitalizations, while the remainder were non-IBD-related.

Between fiscal years 2002-2003 and 2018-2019, all-cause hospitalization rates decreased from 36.57 to 16.72 per every 100 patients with IBD (average annual percentage change [AAPC], -4.18%; 95% CI, -4.69 to -3.66). Specifically, IBD-related hospitalization rates decreased from 26.44 to 9.24 per every 100 patients with IBD (AAPC, -5.54%; 95% CI, -6.19 to -4.88).

Researchers observed a similar trend across non-IBD-related hospitalizations as well with decreasing rates from 10.13 to 7.48 per every 100 patients with IBD (AAPC, -1.82%; 95% CI, -2.14 to -1.49). Patients over the age of 80 years demonstrated the greatest rates of all-cause and non-IBD-related hospitalizations.

These trends of decreasing hospitalization rates over time occurred irrespective of patient age, biological sex, metropolitan or rural location, or type of IBD.

“Hospitalization rates are decreasing for all-cause, IBD-related, and non-IBD-related hospitalizations,” the study authors wrote. “Over the past 20 years, the care of IBD has transitioned from hospital-based care to ambulatory-centric IBD management,” they concluded.

Study limitations include the risk of misclassification of IBD diagnosis, health care accessibility allowing easier access to outpatient services for some patients more than others, and lack of comparison of all-cause hospitalizations between patients with IBD and that of the general population.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.