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Published on: October 29, 2014
Major ambulatory surgery among US adults with inflammatory bowel disease, 2017
Fang Xu1, Anne G Wheaton1, Yong Liu1
1Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
Insights
Patients with inflammatory bowel disease (IBD) undergoing major ambulatory surgery had different characteristics and costs compared to non-IBD patients. These differences may guide resource allocation for better surgical outcomes.
Area of Science:
- Gastroenterology
- Health Services Research
- Surgical Outcomes
Background:
- Patients with inflammatory bowel disease (IBD) exhibit higher healthcare utilization.
- This study examines patient and hospital factors in major ambulatory surgery for Crohn's disease (CD) and ulcerative colitis (UC) versus non-IBD patients.
Purpose of the Study:
- To compare patient and hospital characteristics of major ambulatory surgery encounters for IBD (CD, UC) versus non-IBD patients.
- To identify potential disparities and opportunities for resource allocation and improved surgical outcomes.
Main Methods:
- Cross-sectional study using the 2017 Nationwide Ambulatory Surgery Sample.
- Compared major ambulatory surgery encounters for IBD patients (CD: n=20,635; UC: n=9,894) with non-IBD patients (n=9.4 million).
- Analyzed patient demographics, comorbidities, hospital characteristics, and total charges using weighted percentages and linear regression.
Main Results:
- IBD patients were more likely to have private insurance, live in urban/higher-income areas, and have surgery at private, non-profit, urban teaching hospitals in the Northeast.
- Gastrointestinal surgeries and certain comorbidities were more prevalent in IBD patients.
- Total charges were lower for younger CD patients (<65 years) but higher for older UC patients (≥65 years) compared to non-IBD counterparts.
Conclusions:
- Significant differences exist in the characteristics of major ambulatory surgery encounters between IBD and non-IBD patients.
- These findings highlight opportunities for optimizing resource allocation and enhancing surgical outcomes for IBD patients.
Background:
Patients with inflammatory bowel disease (IBD) have higher health services use than those without IBD. We investigated patient and hospital characteristics of major ambulatory surgery encounters for Crohn's disease (CD) or ulcerative colitis (UC) vs non-IBD patients.
Methods:
We conducted a cross-sectional study using 2017 Nationwide Ambulatory Surgery Sample. Major ambulatory surgery encounters among patients aged ≥18 years with CD (n = 20,635) or UC (n = 9,894) were compared to 9.4 million encounters among non-IBD patients. Weighted percentages of patient characteristics (age, sex, median household income, primary payers, patient location, selected comorbidities, discharge destination, type of surgeries) and hospital-related characteristics (hospital size, ownership, location and teaching status, region) were compared by IBD status (CD, UC, and no IBD). Linear regression was used to estimate mean total charges, controlling for these characteristics.
Results:
Compared with non-IBD patients, IBD patients were more likely to have private insurance, reside in urban areas and higher income zip codes, and undergo surgeries in hospitals that were private not-for-profit, urban teaching, and in the Northeast. Gastrointestinal surgeries were more common among IBD patients. Some comorbidities associated with increased risk of surgical complications were more prevalent among IBD patients. Total charges were 9% lower for CD patients aged <65 years (Median: $16,462 vs $18,106) and 6% higher for UC patients aged ≥65 years (Median: $16,909 vs $15,218) compared to their non-IBD patient counterparts.
Conclusions:
Differences in characteristics of major ambulatory surgery encounters by IBD status may identify opportunities for efficient resource allocation and positive surgical outcomes among IBD patients.
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