Abstract
BACKGROUND: Individuals with inflammatory bowel diseases (IBD) are at increased risk of repeated disease-related hospital admissions, some of which may be preventable with targeted outpatient interventions. We assessed population-level trends in the rates of IBD-specific hospital readmission within 30 and 90 days of index hospitalization among those with Crohn's disease (CD) and ulcerative colitis (UC) during a period marked by major changes to IBD management. METHODS: We accessed Ontario health administrative datasets to study CD (2002-2017) and UC (2004-2020) patients hospitalized for IBD-specific indications. We compared IBD-specific 30-day and 90-day hospital readmission rates across 4 (UC) and 5 (CD) year time periods using multivariable logistic regression, controlling for age, sex, comorbidities, residential setting, household income, hospital type, and clustering of admissions within patients. RESULTS: Among CD patients, 30-day readmission rates decreased from 9.7% to 7.4%, and 90-day rates decreased from 16.0% to 14.1% between 2002-2007 and 2012-2017 periods. There was a higher likelihood of 30-day readmission during 2002-2007 (adjusted odds ratio [aOR] 1.32; 95% CI, 1.16-1.50) and 2007-2012 (aOR 1.15; 95% CI, 1.01-1.32), and of 90-day readmission during 2002-2007 (aOR 1.14; 95% CI, 1.03-1.26), as compared to 2012-2017. Among UC patients, readmission rates remained stable across time periods. CONCLUSION: Inflammatory bowel disease-related early rehospitalization risk has declined over time among individuals with CD but not among individuals with UC.