P4301 - Hospitalization Rates Among Uninsured Patients With Inflammatory Bowel Disease

Garrett T. Coleman, ¹, Raakhi Menon, DO², Anna Archbold, MD², Devin Garza, BS², Hannah Yu, BS², Norman Farr, MD^2
1University of Texas Medical Branch, John Sealy School of Medicine, Galveston, TX; ²University of Texas Medical Branch, Galveston, TX

Introduction: Patients who are uninsured are hospitalized at a greater rate and accrue greater healthcare expenditures. Patients with inflammatory bowel disease (IBD) face higher hospitalization rates and healthcare spending. Tsai et. al 2022 conducted a meta-analysis from 1980-2019 and found that patients with IBD experienced a 1-year risk of IBD-related hospitalization of 19.9%. In patients with Ulcerative Colitis (UC), the 1- and 3-year risk of UC-related hospitalization was 10.4% and 17% respectively. In patients with Crohn’s Disease (CD), the 1- and 3-year risk of CD-related hospitalization was 29.3% and 44.3% respectively. There is limited data analyzing hospitalization rates among uninsured patients with IBD.

Methods: Data was utilized from St. Vincent’s (STV), a free health clinic in Galveston, Texas. Slicer dicer analyzed Epic data for all patients from 2011-2023 using the ICD-10 diagnoses for “IBD”, “Crohn’s Disease”, and “Ulcerative Colitis” (Table 1). One-year hospitalization rates were calculated for the overall (“IBD”), CD, and UC groups and three-year hospitalization rates were calculated for the CD and UC groups (Fig. 1). Mann-Whitney U-test was then performed to determine if there was a significance difference in IBD-related hospitalization rates between the STV and national meta-analysis group.

Results: Results of the Mann-Whitney U-test demonstrated that individuals in the STV sample were hospitalized at a significantly greater rate than the national sample (U = 2, z = 2.089, p = 0.037). Overall, individuals at STV with IBD were 112% more likely to experience a hospitalization in one year than the national sample (RR = 2.12). Individuals at STV with CD were 14% more likely to experience a hospitalization in one year (RR = 1.14) and 13% more likely to experience a hospitalization over three years (RR = 1.13). Individuals at STV with UC were 344% more likely to experience a hospitalization in one year (RR = 4.44) and 216% more likely to experience a hospitalization over three years (RR = 3.16).

Discussion: Patients with IBD who lack health insurance demonstrated higher hospitalization rates than the national average. We propose the implementation of a targeted care program at our free health clinic which would include: post-hospitalization follow-up, access to biologic medications, close outpatient follow-up, social work care, and coordination with our gastroenterology department via charity care would improve patient outcomes while reducing emergency room visits and hospitalizations.



Disclosures:


Garrett T. Coleman, ¹, Raakhi Menon, DO², Anna Archbold, MD², Devin Garza, BS², Hannah Yu, BS², Norman Farr, MD². P4301 - Hospitalization Rates Among Uninsured Patients With Inflammatory Bowel Disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.