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Pediatric hospitalizations for inflammatory bowel disease based on annual case volume: results from the Kids’ Inpatient Database 2012
  1. Chaitanya Pant1,
  2. Abhishek Deshpande2,3,
  3. Thomas J Sferra4,
  4. Osama Almadhoun5,
  5. Daisy Batista1,
  6. Asad Pervez1,
  7. Venkat Nutalapati1,
  8. Mojtaba Olyaee1
  1. 1Department of Internal Medicine, Division of Gastroenterology, Hepatology and Motility, University of Kansas Medical Center, Kansas City, Kansas, USA
  2. 2Medicine Institute Center for Value Based Care Research, Cleveland Clinic, Cleveland, Ohio, USA
  3. 3Division of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
  4. 4Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology & Nutrition, UH Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
  5. 5Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
  1. Correspondence to Dr Chaitanya Pant, Department of Internal Medicine, Division of Gastroenterology, Hepatology and Motility, University of Kansas Medical Center, Kansas City, KS 66160-7300, USA; pant55{at}yahoo.com

Abstract

To study differences related to pediatric inflammatory bowel disease (IBD) care among hospitals that were stratified based on annual case volume. This is a cross-sectional study using data from the United States Healthcare Cost and Utilization Project Kids’ Inpatient Database (KID). IBD-related hospitalizations were identified using International Classification of Diseases-9-Clinical Modification codes. Hospital volume was divided into low or high by assigning cut-off values of 1–20 and >20 annual IBD hospitalizations. We assessed a total of 8647 pediatric IBD discharges during 2012 from 660 hospitals in the USA. 107 of these hospitals were classified as high-volume centers (HVCs) for pediatric IBD care and 553 low-volume centers (LVCs). HVCs were more likely to be associated with an academic teaching status compared to LVCs (97.1% vs 67.6%, p<0.001). The incidence of transfer of medical care from LVCs to other hospitals was 5.5% but only 0.7% for HVCs (p<0.001). The median number of procedures (medical and surgical) performed on children admitted with IBD was higher at HVCs (2 vs 1, p<0.001). IBD admissions at HVCs were more likely to undergo surgical procedures compared to LVCs (17% vs 10%, p<0.001). The incidence of postoperative complications was not significantly different. There were significantly greater hospital costs (median US$11,000 vs US$6,000, p<0.001) and lengths of stay (median 5 days vs 4 days, p<0.001) associated with HVCs compared to LVCs. Pediatric admissions to HVCs for IBD undergo a greater number of medical and surgical procedures and are associated with higher costs and lengthier hospital stays.

  • Inflammatory Bowel Diseases
  • Hospital Charges

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Footnotes

  • Conference Presentation: Presented as a poster at the Advances in IBD meeting, 2015.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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