Factors Associated with Repeated Health Resource Utilization in Patients with Diverticulitis.
Conservative management trends in diverticulitis may lead to increased hospitalizations secondary to repeated attacks. The study aimed to characterize trends in management and risk-assess patients with diverticulitis that required multiple admissions to identify high utilizers. A total of 265,724 patients with diverticulitis were identified from 1995 to 2014 from the New York SPARCS database. Patients with ≥2 hospital admissions were stratified across demographics, comorbidities, insurance status, and surgical intervention. In total, 42,850 patients had ≥2 hospital admissions. Risk factors for ≥2 admissions included younger age, White race, obesity, hypertension, pulmonary disease, hypothyroidism, rheumatoid arthritis, and depression. Fifty-two percent of these patients went on to have surgery. The percentage of elective cases increased from 59 to 70 %, while emergent cases conversely decreased from 41 to 30 %. One in five patients admitted with diverticulitis required two or more admissions. Numerous patient factors were correlated with increased risk of readmission. These factors may be used to guide treatment decisions and help reduce economic burden in frequent utilizers. Trends in surgery rates for these patients could reflect improved treatment options and/or changing clinical practice patterns.
Stony Brook University School of Medicine, Stony Brook University Medical Center, 26 Barker Drive, Stony Brook, NY, 11790, USA. steven.mathews@stonybrookmedicine.edu.
Steven N
SN
Mathews
Stony Brook University School of Medicine, Stony Brook University Medical Center, 26 Barker Drive, Stony Brook, NY, 11790, USA.
Ryan
R
Lamm
Department of Family, Population and Preventative Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA.
Jie
J
Yang
Department of Family, Population and Preventative Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA.
Lijuan
L
Kang
Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA.
Dana
D
Telem
Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA.
Aurora D
AD
Pryor
Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA.
Mark
M
Talamini
Division of Colon and Rectal Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA.
Jill
J
Genua
D000293:Adolescent; D000328:Adult; D017281:Cost of Illness; D004238:Diverticulitis / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009518:New York; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
Diverticulitis; Hospitalization; Management