Impact of Socioeconomic Status on Hospital Length of Stay in Inflammatory Bowel Disease (IBD) Patients

Document Type

Conference Proceeding

Publication Date

10-2024

Publication Title

American Journal of Gastroenterology

Abstract

Introduction: Sociodemographic factors significantly influence in-hospital outcomes for patients in the United States. While cost of care is studied, factors impacting length of stay (LOS) in inflammatory bowel disease (IBD) patients are underexplored. This study aims to fill this gap by examining ethnic disparities, income differences, and insurance types in relation to the LOS stay for IBD patients. Methods: Patients .18 years old with an IBD-related admission (2016-2021) were identified from the National Inpatient Sample database using ICD-10 codes. They were stratified by ethnicity and income quartile. Baseline characteristics were compared using appropriate tests. The primary outcome was LOS, dichotomized at the median of 3 days, and the secondary outcome was in-hospital mortality. Multivariate regression was adjusted for BMI, age, co-morbidities, and gender, and the effects of ethnicity and income on outcomes were analyzed. Variables with a P-value , 0.1 in univariate analysis were included in the final model, with a significance of P , 0.05. Data extraction was conducted with Python (version 3.9.1), and analysis was performed using the survey package in R (version 3.6.2). Results: A total of 184,446 patients of diverse ethnic backgrounds were included in the study. African Americans (AA) had the longest mean LOS at 4.6265.48 days, whereas Whites had the shortest at 4.2964.72 days. Multivariate regression analysis (MVA) indicated that AA had significantly higher odds of LOS .3 days vs Whites (OR 1.04, 95% CI 1.03-1.05, P , 0.001). Predictors of reduced LOS included self-payment (OR 0.96, 95% CI 0.94-0.97, P , 0.001), female gender (OR 0.99, 95% CI 0.98-0.99, P , 0.001), and acute coronary syndrome (ACS) as a comorbidity (OR 0.87, 95% CI 0.85-0.88, P , 0.001). Conversely, predictors of longer LOS were congestive heart failure (OR 1.10, 95% CI 1.09-1.12) and dementia (OR 1.13, 95% CI 1.11-1.15). Income analysis showed that higher median household income was associated with reduced LOS, with the highest income ZIP codes showing the best outcomes (OR 0.97, 95% CI 0.96-0.98). However, income did not demonstrate a significant association with mortality. Conclusion: Despite efforts to equalize outcomes in IBD, African American patients and low-income patients experience longer hospital stays. Future studies should focus on developing targeted interventions to address healthcare disparities and improve hospitalization outcomes for all IBD patients regardless of sociodemographic status (see Table 1)

Volume

119

Issue

10S

First Page

S904

Comments

American College of Gastroenterology Annual Scientific Meeting, October 25-30, 2024, Philadelphia, PA

DOI

10.14309/01.ajg.0001034444.74624.6c

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