IDDF2022-ABS-0214 Hospitalization comorbidities and cost of inflammatory bowel disease in a highland region of yunnan, China, 2015–2020

BackgroundStudies of other immune-mediated diseases demonstrate the management of comorbidities improves cost-effectiveness. However, no large-scale studies and specific guidelines on comorbidities in inflammatory bowel disease (IBD) are available. We sought to define the patterns of major hospitalization comorbidities associated with IBD and explore its impact on hospitalization cost in a southwestern highland region of China.MethodsRecords of inpatients with ulcerative colitis (UC) and Crohn’s disease (CD) from 2015 to 2020 were retrospectively analyzed in a database used to assess the quality of health care services in Yunnan Province. Major comorbidities in IBD inpatients were classified according to different organ systems. An appropriate test was used to assess differences in quantitative variables and categorical variables. Multiple logistic regression models were used to quantify the relationship between comorbidities and hospitalization cost.ResultsAfter reviewing 12,174 records, we found that comorbidities were common among inpatients with IBD (72.1%). In inpatient with IBD, the comorbidities assigned to different organ systems were endocrine and metabolic diseases (21.6%), infectious diseases (16.7%), cardiovascular disease (15.2%), hepatobiliary diseases (14.9%), respiratory disease (12.4%), hematological diseases (10.6%), urological diseases (10.3%), spinal and joint diseases (7.0%), neurological diseases (3.9%), malignancy (3.0%), immunopathy (2.2%), dermatosis (1.6%), psychiatric disorders (1.6%),and oculopathy (0.5%), respectively. The mean hospitalization cost for patients with CD was higher than that for patients with UC (¥11846.77 vs ¥7421.01, P<0.001) from 2015 to 2020. Among the itemized payments, drug cost accounts for the highest proportion. In addition, comorbidities are associated with higher hospitalization cost in IBD inpatients. The results of the multinomial logistic regression models showed that the existence of comorbidities, including malnutrition, infectious disease, hematological diseases, endocrine and metabolic diseases, respiratory disease, malignancy and immunopathy were associated with a higher hospitalization cost in UC, and hematological diseases were risk factors for high hospitalization cost in CD.ConclusionsComorbidities should be carefully investigated, as they can further complicate the management of the patients with IBD and result in high hospitalization costs. Our findings suggest that comorbidities in IBD require more multidisciplinary management and financial compensation.