P5483 - Hospitalization in Inflammatory Bowel Disease Is Associated With Substantial Direct and Indirect Costs: A National MEPS-Based Analysis

Janak Bahirwani, MD¹, Madhav Changela, MD², Maulik Kaneriya, MD², Sanket Patel, DO³, Jashanveer S. Singh Johal, MD⁴, Yecheskel Schneider, MD, MS⁵
1Kadlec Regional Medical Center, Richland, WA; 2One Brooklyn Health-Interfaith Medical Center, Brooklyn, NY; 3Virtua Health System / Virtua Medical Group, Moorestown, NJ; 4Virtua Health System / Virtua Medical Group, Camden, NJ; 5Virtua Health System, Moorestown, NJ

Introduction: Inflammatory bowel disease (IBD) is associated with high healthcare utilization, particularly during disease flares that lead to hospitalization. However, nationally representative data capturing both direct medical costs and indirect productivity losses related to IBD hospitalizations are limited.

Methods: We conducted a cross-sectional analysis of adults with IBD using the Medical Expenditure Panel Survey (MEPS) from 2018–2022. Hospitalization was defined as ≥1 inpatient stay in the survey year. Outcomes included total healthcare expenditures, out-of-pocket spending, and missed workdays. Multivariable and inverse-probability-of-treatment weighted (IPTW) models adjusted for demographics, insurance, poverty, steroid use, mental health, employment, and comorbidities. We stratified models by pre- vs. post-COVID periods and evaluated interaction terms.

Results: Among 342 adults with IBD, 61 (17.8%) were hospitalized. Hospitalized individuals had higher annual costs ($52,586 vs. $25,730; p< 0.001) and missed more workdays (8.7 vs. 0.5; p=0.025). In adjusted models, hospitalization was associated with a 3.15-fold increase in total costs (95% CI 2.39–4.15; p< 0.001) and a 5.09-fold increase in missed workdays (95% CI 2.97–8.71; p< 0.001). These findings remained robust after Inverse Probability of Treatment Weighting (IPTW) adjustment and accounting for comorbidities. Post-COVID, the cost ratio fell to 1.4×, while the productivity impact remained high (IRR 4.2).

Discussion: IBD-related hospitalization imposes a significant and persistent burden in both direct healthcare spending and lost productivity. These findings underscore the importance of targeted interventions to reduce admissions and support work functionality in patients with IBD.


Figure: Table 1. Baseline Characteristics of Adults with IBD by Hospitalization Status


Figure: Unadjusted and Adjusted outcomes by Hospitalization Status.

Disclosures:
Janak Bahirwani indicated no relevant financial relationships.
Madhav Changela indicated no relevant financial relationships.
Maulik Kaneriya indicated no relevant financial relationships.
Sanket Patel indicated no relevant financial relationships.
Jashanveer Singh Johal indicated no relevant financial relationships.
Yecheskel Schneider indicated no relevant financial relationships.

Janak Bahirwani, MD¹, Madhav Changela, MD², Maulik Kaneriya, MD², Sanket Patel, DO³, Jashanveer S. Singh Johal, MD⁴, Yecheskel Schneider, MD, MS⁵. P5483 - Hospitalization in Inflammatory Bowel Disease Is Associated With Substantial Direct and Indirect Costs: A National MEPS-Based Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.