Increasing thirty-day readmissions of Crohn’s disease and ulcerative colitis in the United States: A national dilemma

Table 1 Biodemographic characteristics and hospitalization trends for 30 d readmissions of Crohn’s disease

Variable	Year
	2010	2012	2014	2016	2018
Number of readmissions	6202	6580	6475	8278	7672
Age (mean ± SE, yr)	41.8 ± 0.9	41.6 ± 1.1	41.2 ± 0.8	42.5 ± 0.7	43.9 ± 0.7
Gender (%)
Males	45.5	44.0	45.7	46.7	46.5
Females	54.5	56.0	54.3	53.3	53.5
Charlson comorbidity index score (%)
0	69.7	72.0	69.9	64.9	61.3
1	19.2	15.5	17.3	19.5	20.0
2	5.9	6.1	6.7	7.5	9.0
≥ 3	5.2	6.4	6.1	8.1	9.7
Insurance type (%)
Medicare	20.5	29.1	29.3	28.9	30.6
Medicaid	21.5	24.9	26.4	25.5	24.7
Private	41.2	37.1	37.0	40.8	39.0
Uninsured	8.8	8.9	7.3	4.8	5.7
Household income quartile (%)
1st	27.8	29.2	27.9	29.0	28.6
2nd	23.4	25.6	28.5	26.8	30.0
3rd	24.9	25.1	22.5	24.5	23.7
4th	23.9	20.1	21.1	19.7	17.7
Hospital characteristics
Hospital bed size (%)
Small	9.9	9.9	14.2	13.3	15.0
Medium	22.4	22.4	27.3	26.9	26.3
Large	67.7	67.7	58.5	59.8	58.7
Teaching status (%)
Metropolitan non-teaching	39.2	34.4	25.2	21.8	17.3
Metropolitan teaching	52.1	56.8	68.4	72.3	77.0
Non-metropolitan	8.7	8.8	6.4	5.9	5.7
Hospital volume quintiles (%)
Q1	1.8	1.9	1.5	1.7	1.3
Q2	4.3	5.4	5.1	4.2	4.5
Q3	10.3	10.0	10.2	8.4	10.4
Q4	19.4	18.1	18.1	18.6	19.1
Q5	64.2	64.6	65.1	67.1	64.7

Table 2 Biodemographic characteristics and hospitalization trends for 30 d readmissions of ulcerative colitis

Variable	Year
	2010	2012	2014	2016	2018
Number of readmissions	3272	3399	3426	4449	4234
Age (mean ± SE, yr)	49.8 ± 1.6	49.6 ± 1.5	48.4 ± 1.1	49.9 ± 1.0	51.2 ± 0.8
Gender (%)
Males	48.1	45.6	47.5	46.7	49.4
Females	51.9	54.4	52.5	53.3	50.6
Charlson comorbidity index score (%)
0	57.8	59.6	60.6	55.6	50.9
1	20.3	20.0	18.6	19.4	20.7
2	9.4	9.0	8.5	10.6	10.3
≥ 3	12.5	11.4	12.3	14.4	18.1
Insurance type (%)
Medicare	36.3	36.6	32.4	35.1	34.8
Medicaid	17.8	17.0	22.3	17.5	19.5
Private	39.4	37.0	40.1	42.2	40.4
Uninsured	6.5	9.4	5.2	5.2	5.3
Household income quartile (%)
1st	25.5	29.2	26.5	27.2	25.0
2nd	22.5	23.1	25.9	27.5	26.7
3rd	26.4	24.6	22.9	25.0	26.1
4th	25.6	23.1	24.7	20.3	22.2
Hospital characteristics
Hospital bed size (%)
Small	10.2	9.8	13.2	13.5	16.8
Medium	19.8	22.4	26.8	25.7	24.3
Large	70.0	67.8	60.0	60.8	58.9
Teaching status (%)
Metropolitan non-teaching	37.3	38.2	26.1	24.5	19.3
Metropolitan teaching	53.6	53.5	67.7	70.3	76.3
Non-metropolitan	9.1	8.3	6.2	5.2	4.4
Hospital volume quintiles (%)
Q1	2.4	2.4	2.5	2.1	2.0
Q2	6.0	7.4	5.9	5.8	5.5
Q3	11.8	10.5	11.7	10.3	12.3
Q4	20.2	20.1	19.0	20.4	21.4
Q5	59.6	59.6	60.9	61.4	58.8

Table 3 Readmission rates, inpatient mortality, and healthcare burden for 30 d readmissions of Crohn’s disease and ulcerative colitis

Outcomes	Year					P trend
	2010	2012	2014	2016	2018
Crohn’s disease
All-cause readmission rate (%)	14.9	15.5	15.2	18.9	17.6	< 0.001
Crohn’s disease specific readmission rate (%)	7.1	6.9	7.0	8.9	8.2	< 0.001
Crohn’s disease readmission proportion (%)	54.9	51.8	53.0	55.8	54.6	0.002
Inpatient mortality (%)	0.9	1.4	0.7	0.7	1.0	0.059
Mean length of stay (d)	5.9	5.9	5.3	6.0	6.2	0.927
Mean total hospital cost (USD)	12327	13068	10988	13421	14260	0.210
Ulcerative colitis
All-cause readmission rate (%)	14.1	14.2	13.5	16.6	15.7	0.003
Ulcerative colitis specific readmission rate (%)	5.2	5.3	5.2	6.1	5.6	0.029
Ulcerative colitis readmission proportion (%)	42.6	42.4	43.4	43.0	41.0	0.566
Inpatient mortality (%)	2.5	1.8	2.2	2.0	2.3	0.912
Mean length of stay (d)	6.8	6.8	6.3	6.8	6.9	0.452
Mean total hospital cost (USD)	13783	13568	13790	15358	15929	0.009