Department of Pharmacology, Faculty of Pharmacy, Riga Stradiņš University, LV-1007 Riga, Latvia.
Faculty of Medicine, Riga Stradiņš University, LV-1007 Riga, Latvia.
Medicina (Kaunas). 2024 Aug 13;60(8):1310. doi: 10.3390/medicina60081310.
Inflammatory bowel disease (IBD) prevalence in Eastern Europe is increasing. The 30-day readmission rate is a crucial quality metric in healthcare, reflecting the effectiveness of initial treatment and the continuity of care post-discharge; however, such parameters are rarely analyzed. The aim of this study was to explore the trends in 30-day readmissions among patients with inflammatory bowel disease in Latvia between 2014 and 2020. This is a retrospective trends study in IBD-ulcerative colitis and Crohn's disease (UC and CD)-patients in Latvia between 2014 and 2020, involving all IBD patients identified in the National Health service database in the International Classification of Diseases-10 (ICD) classification (K50.X and K51.X) and having at least one prescription for IBD diagnoses. We assessed all IBD-related hospitalizations (discharge ICD codes K50X and K51X), as well as hospitalizations potentially related to IBD comorbidities. We analyzed hospitalization trends and obtained the 30 day all-cause readmission rate, disease specific readmission rate and readmission proportion for specific calendar years. Trends in readmissions and the mean length of stay (LOS) for CD and UC were calculated. Despite a decrease in admission rates observed in 2020, the total number of readmissions for CD and UC has increased. Female patients prevailed through the study period and were significantly older than male patients in both the CD and UC groups, < 0.05. We noted that there was no trend for 30 day all-cause readmission rate for CD ( > 0.05); however, there was a statistically significant trend for 30 day all-cause readmission for UC patients (-trend = 0.018) in the period from 2014 to 2019. There was a statistically significant trend for CD-specific readmission rate ( < 0.05); however, no statistically significant trend was observed for UC-specific readmission ( > 0.05). An exploratory analysis did not reveal any statistically significant differences between treated and not-treated IBD patients ( > 0.05). The increasing trend is statistically significant over the period 2014-2018 ( < 0.05); however, the trend interrupts in 2020, which can be associated with the COVID-19 global pandemic and the related changes in admission flows where the gastroenterology capacity was reallocated to accommodate increasing numbers of COVID-19 patients. More studies are needed to evaluate the long-term impact of COVID-19 pandemic and 30-day readmissions. No significant dynamics were observed in the mean total hospitalization costs over the 2014-2020 period.
东欧的炎症性肠病（IBD）患病率正在上升。30 天再入院率是医疗保健中一个重要的质量指标，反映了初始治疗的效果和出院后的护理连续性；然而，此类参数很少被分析。本研究旨在探讨 2014 年至 2020 年间拉脱维亚 IBD 患者 30 天再入院的趋势。这是一项在拉脱维亚 2014 年至 2020 年间 IBD-溃疡性结肠炎和克罗恩病（UC 和 CD）患者中进行的回顾性趋势研究，涉及国家卫生服务数据库中 ICD-10 分类（K50.X 和 K51.X）中确定的所有 IBD 患者，并且至少有一次 IBD 诊断的处方。我们评估了所有与 IBD 相关的住院治疗（出院 ICD 代码 K50X 和 K51X），以及可能与 IBD 合并症相关的住院治疗。我们分析了住院治疗趋势，并获得了特定日历年份的 30 天全因再入院率、疾病特异性再入院率和再入院比例。计算了 CD 和 UC 再入院率和平均住院时间（LOS）的趋势。尽管 2020 年观察到入院率下降，但 CD 和 UC 的再入院总数有所增加。女性患者在整个研究期间占主导地位，并且在 CD 和 UC 组中均显著大于男性患者，<0.05。我们注意到，CD 的 30 天全因再入院率没有趋势（>0.05）；然而，UC 患者的 30 天全因再入院率存在统计学显著趋势（-趋势=0.018），时间为 2014 年至 2019 年。CD 特异性再入院率呈统计学显著趋势（<0.05）；然而，UC 特异性再入院率没有观察到统计学显著趋势（>0.05）。探索性分析未发现接受和未接受治疗的 IBD 患者之间有统计学差异（>0.05）。2014 年至 2018 年期间，上升趋势具有统计学意义（<0.05）；然而，2020 年趋势中断，这可能与 COVID-19 全球大流行以及相关的入院流量变化有关，其中胃肠病学能力被重新分配以容纳越来越多的 COVID-19 患者。需要进一步研究以评估 COVID-19 大流行和 30 天再入院的长期影响。2014-2020 年期间，总住院费用的平均总住院费用没有明显变化。
