Physician density and hospitalization for inflammatory bowel disease

Area of Science:

• Gastroenterology
• Health Services Research
• Public Health

Background:

• Inflammatory bowel diseases (IBD) are chronic conditions necessitating consistent healthcare engagement.
• Adequate physician availability may mitigate IBD complications and hospitalizations.
• Understanding the impact of physician density on IBD patient outcomes is crucial for healthcare planning.

Purpose of the Study:

• To investigate the association between county-level physician density and the characteristics of inflammatory bowel disease (IBD) hospitalizations.
• To determine if higher availability of primary care physicians and gastroenterologists influences IBD patient outcomes, including complication rates and hospitalization charges.

Main Methods:

• Utilized 2008 Wisconsin inpatient data and ICD-9-CM codes to identify IBD hospitalizations.
• Calculated county-level physician density using data from the American Medical Association and US Census Bureau.
• Employed multivariate regression analysis to assess the independent effect of physician density on IBD hospitalization outcomes.

Main Results:

• Counties with high physician density had fewer hospitalizations with complications such as hypovolemia, malnutrition, and Clostridium difficile infection.
• Patients in high-density counties were less likely to require emergent admission or total parenteral nutrition (TPN).
• Residence in high physician density areas correlated with a 4% shorter hospital stay and 10% lower charges.

Conclusions:

• Higher physician density in counties is linked to less complicated inflammatory bowel disease (IBD) hospitalizations.
• Increased access to healthcare providers is associated with reduced hospitalization costs for IBD patients.
• These findings underscore the importance of physician distribution in managing chronic diseases effectively.