Faculty Collaboration Database

Trends in ambulatory and emergency room visits for inflammatory bowel diseases in the United States: 1994-2005. Am J Gastroenterol 2010 Feb;105(2):363-70

Date

10/08/2009

Pubmed ID

19809414

DOI

10.1038/ajg.2009.580

Scopus ID

2-s2.0-76349106196 (requires institutional sign-in at Scopus site)   48 Citations

Abstract

OBJECTIVES: Inflammatory bowel diseases (IBDs) require frequent healthcare encounters. Analysis of trends in disease burden is important to study the changing epidemiology of disease. The aim of our study was to examine national trends in IBD-related visits in ambulatory and emergency room (ER) settings.

METHODS: We used data from the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) using the International Classification of Diseases, 9th Revision, Clinical Modification codes to identify IBD-related visits. The annualized number of visits was examined in 3-year time periods from 1994 to 2005. We compared the demographic distribution of the inpatient, outpatient, and ER IBD cohorts.

RESULTS: There were an estimated 1.1 million (95% confidence interval (CI): 0.9-1.4 million) annual IBD-related visits during the period 1994-1996 increasing to 1.8 million (95% CI: 1.4-2.2 million) visits during 2003-2005 (+55%). Correspondingly, there were 28,752 estimated annual ER visits (95% CI: 16,299-41,206) related to IBD during 1994-1996 increasing to 76,374 annual visits (95% CI: 42,498-112,257) during 2003-2005 (+165%). The proportion of outpatient visits by patients older than 50 years increased from 34.1 to 52.0% (P<0.0001). Use of corticosteroids decreased from 26.5% of visits to 14.5% (P<0.0001), with a corresponding rise in immunomodulator/biologic use (2.6-13.8%, P<0.0001). Younger, self-pay patients and those with Crohn's disease were over-represented in the ER IBD cohort compared with inpatients or outpatients.

CONCLUSIONS: There has been an increase in IBD-related ambulatory and ER visits from 1994 to 2005. There is a need for research examining the reasons for the disproportionate representation of certain demographic groups in the ER setting.

Author List

Ananthakrishnan AN, McGinley EL, Saeian K, Binion DG

Authors

Emily L. McGinley MS, MPH Biostatistician III in the Center for Advancing Population Science department at Medical College of Wisconsin
Kia Saeian MD Interim Chief, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Age Factors
Ambulatory Care
Cohort Studies
Emergency Service, Hospital
Female
Health Care Surveys
Humans
Inflammatory Bowel Diseases
Male
Middle Aged
Outpatient Clinics, Hospital
Retrospective Studies
Risk Factors
United States