Changes in Hospital Care for Children With IBD Across Australia From 2014 to 2022

Inflammatory bowel disease is a chronic, lifelong gastrointestinal disorder, with 8%-10% of patients diagnosed < 18 years old. Over the last decade, there has been a global increase in paediatric IBD (pIBD) incidence and changes in therapeutic approaches. Our study aimed to assess the changes in hospital care for young people with IBD from 2014 to 2022.

Complete national pIBD data on admissions was collected through the Australian Institute of Health and Welfare (AIHW). Hospitals nationally were invited to participate in a clinical audit of inpatient overnight admissions for 2021. Data was compared to a previous study from 2014.

There were 813 overnight pIBD admissions in 2021, compared to 590 in 2014. Eight public hospitals participated, with 186 admissions, capturing 23% of all 2021 pIBD admissions. UC admission rates doubled; however, surgical admissions reduced (16% in 2014 to 5% in 2021, p < 0.05). CD and surgical admissions remained stable. There was reduced corticosteroid use, and 56 patients had off-label medication use. Sixty-five percent of patients had active disease at the last clinic review. There was a trend towards shorter admissions, and re-admission rates were similar to previous global data. Despite psychological co-morbidity in 28% of cases, psychologists were not part of the team at any site.

This study showed a significant increase in UC admissions in Australia over the last decade. Medication changes were in line with global trends, and multi-disciplinary care remained inadequate despite national standards. This data provides evidence for planning and resourcing pIBD care nationally and worldwide.