Risk factors for recurrent emergency care utilization for flares in inflammatory bowel disease

Area of Science:

• Gastroenterology
• Health Services Research
• Epidemiology

Background:

• Inflammatory bowel disease (IBD) patients often need emergency care for disease flares.
• Predicting which patients are at high risk for recurrent emergency department (ED) visits remains a challenge.

Purpose of the Study:

• To identify patient characteristics associated with repeat ED visits within six months of an initial IBD-related ED visit.
• To inform targeted interventions for high-risk IBD patients.

Main Methods:

• Retrospective cohort study of adult Kaiser Permanente Northern California members (2009-2018).
• Analyzed demographic, clinical, and healthcare utilization data.
• Used multivariable negative binomial regression to assess the risk of recurrent ED visits within six months.

Main Results:

• 19.3% of 2111 IBD patients had a repeat ED visit within six months.
• Factors associated with increased risk included mood disorders, opiate prescriptions, and corticosteroid prescriptions.
• Older age, higher income, and alcohol use disorder were associated with decreased risk.

Conclusions:

• Several patient factors predict recurrent ED utilization for IBD flares.
• Targeted interventions for high-risk individuals (e.g., those with mood or opiate use disorders) may improve care.
• Outpatient follow-up timing did not significantly reduce repeat ED visits in this cohort.