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Hospitalizations for Inflammatory Bowel Disease Among Medicare Fee-for-Service Beneficiaries - United States,
Fang Xu1, Anne G Wheaton1, Yong Liu1
1Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.
Insights
Hospitalization rates for inflammatory bowel disease (IBD) in older adults are rising, with concerning trends for Black beneficiaries. Focus on preventive care to reduce emergency surgeries and improve outcomes for this growing population.
Area of Science:
- Gastroenterology
- Public Health
- Geriatrics
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, involves chronic gastrointestinal inflammation.
- IBD incidence and prevalence are increasing globally, with a growing older adult population experiencing the condition.
- Older adults with IBD face poorer hospitalization outcomes compared to younger individuals.
Purpose of the Study:
- To estimate IBD-related hospitalization rates and outcomes in US adults aged 65 and older.
- To analyze trends in hospitalization rates by race/ethnicity from 1999 to 2017.
- To identify disparities in healthcare utilization among different demographic groups.
Main Methods:
- Analysis of Medicare Provider Analysis and Review (MedPAR) data for fee-for-service beneficiaries aged ≥65 years.
- Estimation of age-adjusted hospitalization and surgery rates for Crohn's disease and ulcerative colitis in 2017.
- Examination of hospitalization rate trends by race/ethnicity between 1999 and 2017.
Main Results:
- In 2017, age-adjusted hospitalization rates were 15.5/100,000 for Crohn's disease and 16.2/100,000 for ulcerative colitis.
- IBD-associated surgery rates were 17.4/100 hospital stays for Crohn's disease and 11.2/100 stays for ulcerative colitis.
- Hospitalization rates decreased for non-Hispanic white beneficiaries but not for non-Hispanic black beneficiaries from 1999-2017.
Conclusions:
- Significant healthcare utilization assessment is required for Black beneficiaries with IBD.
- Disease management strategies for older adults with IBD should prioritize preventive care.
- Interventions aimed at preventing emergency surgeries are crucial for improving outcomes and reducing complications.
Abstract:
Crohn's disease and ulcerative colitis, collectively referred to as inflammatory bowel disease (IBD), are conditions characterized by chronic inflammation of the gastrointestinal tract. The incidence and prevalence of IBD is increasing globally, and although the disease has little impact on mortality, the number of older adults with IBD is expected to increase as the U.S. population ages (1). Older adults with IBD have worse hospitalization outcomes than do their younger counterparts (2). CDC analyzed Medicare Provider Analysis and Review (MedPAR) data to estimate IBD-related hospitalization rates and hospitalization outcomes in 2017 among Medicare fee-for-service beneficiaries aged ≥65 years, by selected demographics and trends in hospitalization rates and by race/ethnicity during 1999-2017. In 2017, the age-adjusted hospitalization rate for Crohn's disease was 15.5 per 100,000 Medicare enrollees, and the IBD-associated surgery rate was 17.4 per 100 hospital stays. The age-adjusted hospitalization rate for ulcerative colitis was 16.2 per 100,000 Medicare enrollees, and the surgery rate was 11.2 per 100 stays. During 1999-2017, the hospitalization rate for both Crohn's disease and ulcerative colitis decreased among non-Hispanic white (white) beneficiaries, but not among non-Hispanic black (black) beneficiaries. Health care utilization assessment is needed among black beneficiaries with IBD. Disease management for older adults with IBD could focus on increasing preventive care and preventing emergency surgeries that might result in further complications.
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