| Characteristic | No. of hospitalizations | Hospitalization rate,§ (95% CI) | Surgery rate,¶,**,†† (95% CI) | 30-Day readmission rate,¶,§§ (95% CI) | 30-Day mortality rate,¶,¶¶ (95% CI) | Length of stay (days)** geometric mean,*** (95% CI) |
|---|---|---|---|---|---|---|
| Crohn’s disease††† | ||||||
| Total | 4,782 | 15.5 (15.0–15.9) | 17.4 (16.3–18.4) | 15.8 (14.5–17.1) | 2.7 (2.2–3.1) | 3.9 (3.8–4.0) |
| Age group (yrs) | ||||||
| 65–74 | 2,912 | 17.1 (16.5–17.7) | 19.3 (17.8–20.7) | 15.4 (13.7–17.0) | 1.7 (1.2–2.1) | 3.8 (3.7–3.9) |
| ≥75 | 1,870 | 13.7 (13.1–14.4) | 14.4 (12.8–16.0) | 16.5 (14.3–18.7) | 4.2 (3.3–5.1) | 4.1 (3.9–4.2) |
| Sex | ||||||
| Men | 2,001 | 14.1 (13.5–14.8) | 19.0 (17.3–20.8) | 17.6 (15.5–19.7) | 3.0 (2.3–3.8) | 3.8 (3.6–3.9) |
| Women | 2,781 | 16.7 (16.1–17.3) | 16.1 (14.8–17.5) | 14.5 (12.7–16.1) | 2.4 (1.8–3.0) | 4.0 (3.9–4.1) |
| Race/Ethnicity | ||||||
| White, non-Hispanic | 4,227 | 16.9 (16.4–17.5) | 17.5 (16.4–18.7) | 16.1 (14.6–17.5) | 2.6 (2.1–3.0) | 4.0 (3.9–4.0) |
| Black, non-Hispanic | 250 | 10.3 (9.0–11.5) | 10.8 (7.0–14.6) | 14.7 (9.1–20.2) | —§§§ | 4.2 (4.0–4.5) |
| Other or unknown¶¶¶ | 305 | 8.8 (7.8–9.8) | 20.3 (15.8–24.8) | 13.1 (8.3–17.7) | —§§§ | 4.1 (3.8–4.3) |
| Beneficiary residence**** | ||||||
| Urban | 3,938 | 16.0 (15.5–16.5) | 17.0 (15.8–18.2) | 16.1 (14.6–17.5) | 2.6 (2.1–3.1) | 3.9 (3.8–4.0) |
| Rural | 844 | 13.4 (12.5–14.3) | 19.0 (16.3–21.6) | 14.5 (11.3–17.7) | 3.1 (1.9–4.3) | 3.8 (3.7–4.0) |
| Ulcerative colitis††† | ||||||
| Total | 4,932 | 16.2 (15.8–16.7) | 11.2 (10.3–12.1) | 16.0 (14.6–17.3) | 3.8 (3.3–4.4) | 4.1 (4.0–4.2) |
| Age group (yrs) | ||||||
| 65–74 | 2,395 | 14.1 (13.5–14.6) | 15.6 (14.1–17.0) | 14.5 (12.7–16.3) | 2.1 (1.5–2.7) | 4.1 (4.0–4.3) |
| ≥75 | 2,537 | 18.6 (17.9–19.4) | 7.0 (6.0–8.0) | 17.4 (15.5–19.3) | 5.5 (4.6–6.4) | 4.0 (3.9–4.2) |
| Sex | ||||||
| Men | 1,872 | 13.5 (12.9–14.2) | 16.9 (15.2–18.6) | 17.6 (15.3–19.8) | 4.0 (3.1–4.9) | 4.2 (4.1–4.4) |
| Women | 3,060 | 18.4 (17.7–19.0) | 7.6 (6.7–8.6) | 15.0 (13.4–16.6) | 3.7 (3.1–4.4) | 4.0 (3.9–4.1) |
| Race/Ethnicity | ||||||
| White, non-Hispanic | 4,205 | 17.0 (16.5–17.5) | 11.5 (10.6–12.5) | 16.0 (14.6–17.4) | 4.0 (3.4–4.6) | 4.0 (3.9–4.0) |
| Black, non-Hispanic | 325 | 14.0 (12.4–15.5) | 7.1 (4.3–9.9) | 18.9 (13.5–24.1) | —§§§ | 4.2 (4.0–4.5) |
| Other or unknown¶¶¶ | 402 | 12.0 (10.8–13.3) | 10.7 (7.7–13.7) | 13.2 (8.9–17.4) | —§§§ | 4.1 (3.8–4.3) |
| Beneficiary residence**** | ||||||
| Urban | 4,110 | 17.0 (16.5–17.6) | 10.8 (9.9–11.8) | 16.2 (14.7–17.6) | 3.9 (3.3–4.5) | 4.1 (4.0–4.2) |
| Rural | 819 | 13.2 (12.2–14.1) | 12.9 (10.6–15.2) | 14.9 (11.5–18.1) | 3.4 (2.2–4.7) | 4.0 (3.8–4.2) |
Abbreviation: CI = confidence interval.
*IBD encompasses Crohn’s disease and ulcerative colitis.
†The number of eligible Medicare beneficiaries aged ≥65 years in 2017 in the United States was approximately 30,658,000.
§Hospitalizations per 100,000 Medicare enrollees, age-adjusted to the 2000 U.S. Standard Population aged ≥65 years based on two age groups (65–74 years and ≥75 years), except for age-specific analysis. https://www.cdc.gov/nchs/data/statnt/statnt20.pdf.
¶Per 100 hospital stays.
**The denominator is number of hospital admissions. To calculate surgery rate and geometric mean of length of stay, n = 4,782 for Crohn’s disease and n = 4,932 for ulcerative colitis.
†† International Classification of Diseases, Tenth Edition, Procedure Coding System procedure codes involving small and large intestine include partial resection (0DB80ZZ, 0DB90ZZ, 0DBA0ZZ, 0DBB0ZZ, 0DBC0ZZ, 0DBE0ZZ, 0DBF0ZZ, 0DBG0ZZ, 0DBH0ZZ, 0DBK0ZZ, 0DBL0ZZ, 0DBM0ZZ, 0DBN0ZZ, 0DBP0ZZ, 0DB83ZZ, 0DB93ZZ, 0DBA3ZZ, 0DBB3ZZ, 0DBC3ZZ, 0DBE3ZZ, 0DBF3ZZ, 0DBG3ZZ, 0DBH3ZZ, 0DBK3ZZ, 0DBL3ZZ, 0DBM3ZZ, 0DBN3ZZ, 0DBP3ZZ, 0DB84ZZ, 0DB94ZZ, 0DBA4ZZ, 0DBB4ZZ, 0DBC4ZZ, 0DBE4ZZ, 0DBF4ZZ, 0DBG4ZZ, 0DBH4ZZ, 0DBK4ZZ, 0DBL4ZZ, 0DBM4ZZ, 0DBN4ZZ, 0DBP4ZZ, 0DB87ZZ, 0DB97ZZ, 0DBA7ZZ, 0DBB7ZZ, 0DBC7ZZ, 0DBE7ZZ, 0DBF7ZZ, 0DBG7ZZ, 0DBH7ZZ, 0DBK7ZZ, 0DBL7ZZ, 0DBM7ZZ, 0DBN7ZZ, 0DBP7ZZ, 0DB88ZZ, 0DB98ZZ, 0DBA8ZZ, 0DBB8ZZ, 0DBC8ZZ, 0DBE8ZZ, 0DBF8ZZ, 0DBG8ZZ, 0DBH8ZZ, 0DBK8ZZ, 0DBL8ZZ, 0DBM8ZZ, 0DBN8ZZ, 0DBP8ZZ) and total resection (0DT80ZZ, 0DT90ZZ, 0DTA0ZZ, 0DTB0ZZ, 0DTC0ZZ, 0DTE0ZZ, 0DTF0ZZ, 0DTG0ZZ, 0DTH0ZZ, 0DTK0ZZ, 0DTL0ZZ, 0DTM0ZZ, 0DTN0ZZ, 0DTP0ZZ, 0DT84ZZ, 0DT94ZZ, 0DTA4ZZ, 0DTB4ZZ, 0DTC4ZZ, 0DTE4ZZ, 0DTF4ZZ, 0DTG4ZZ, 0DTH4ZZ, 0DTK4ZZ, 0DTL4ZZ, 0DTM4ZZ, 0DTN4ZZ, 0DTP4ZZ, 0DT87ZZ, 0DT97ZZ, 0DTA7ZZ, 0DTB7ZZ, 0DTC7ZZ, 0DTE7ZZ, 0DTF7ZZ, 0DTG7ZZ, 0DTH7ZZ, 0DTK7ZZ, 0DTL7ZZ, 0DTM7ZZ, 0DTN7ZZ, 0DTP7ZZ, 0DT88ZZ, 0DT98ZZ, 0DTA8ZZ, 0DTB8ZZ, 0DTC8ZZ, 0DTE8ZZ, 0DTF8ZZ, 0DTG8ZZ, 0DTH8ZZ, 0DTK8ZZ, 0DTL8ZZ, 0DTM8ZZ, 0DTN8ZZ, 0DTP8ZZ).§§30-day readmission rate was calculated as the number of all-cause readmissions to acute care, nonfederal hospitals within 30 days from the discharge date associated with an index admission per 100 stays. Index admissions were nonfederal acute-care hospital admissions with Crohn’s disease or ulcerative colitis as the principal diagnosis, had a live discharge, and had a routine discharge to home or skilled nursing facility. To ensure the calculation of the complete 30-day readmission, index admissions with discharge date in December 2017 were excluded. Readmissions were defined as all-cause acute admissions whose discharge destinations were not against medical advice or expired. Multiple readmissions within the 30-day time frame from one index admission were counted as one readmission. A readmission from a previous index admission could be also counted as a new index admission if it met the selection criteria for an index admission (https://www.medicare.gov/hospitalcompare/data/30-day-measures.html). To calculate 30-day all-cause readmission rate, n = 3,022 for Crohn’s disease; n = 3,060 for ulcerative colitis.
¶¶30-day mortality rate was defined as number of all-cause deaths occurred within 30 days from IBD-related admissions per 100 hospital stays. Hospitalizations were excluded if patients were discharged against medical advice. More information is available at https://www.medicare.gov/hospitalcompare/data/30-day-measures.html. To calculate 30-day all-cause readmission rate, n = 4,781 for Crohn’s disease; n = 4,932 for ulcerative colitis.
***Geometric mean is the xth root of the product of the length of stay (days) from x patients (x indicates the number of patients), which, because it is not influenced by outliers, is used here rather than arithmetic mean.
††† International Classification of Diseases, Tenth Edition, Clinical Modification diagnosis codes K50 (Crohn’s disease) and K51 (ulcerative colitis).
§§§Data were suppressed according to the cell size suppression (https://www.resdac.org/articles/cms-cell-size-suppression-policy) or if the relative standard error was >0.3.
¶¶¶Other includes Hispanic, Asian, Native American, and all others.
****Urban areas include large metro, large fringe metro, medium metro, or small metro. Rural areas include micropolitan and noncore. The definition is based on 2013 National Center for Health Statistics Urban-Rural Classification Scheme for Counties (https://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf).
