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Lancet Gastroenterol Hepatol. 2019 Apr;4(4):287-295. doi: 10.1016/S2468-1253(19)30013-5. Epub 2019 Feb 12.

Trends in hospitalisation rates for inflammatory bowel disease in western versus newly industrialised countries: a population-based study of countries in the Organisation for Economic Co-operation and Development.

Author information

1
Department of Medicine and Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
2
Inflammatory Bowel Disease Outpatients Clinic, Colorectal Surgery Unit, Catholic University of Paraná, Curitiba, Brazil.
3
Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
4
National Institute for Health Research Biomedical Research Centre, University of Birmingham and University Hospitals National Health Service Foundation Trust, Birmingham, UK.
5
First Department of Medicine, Semmelweis University, Budapest, Hungary; Division of Gastroenterology, McGill University Health Centre, McGill University, Montreal, QC, Canada.
6
Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
7
Department of Gastroenterology, Sheba Medical Center, Tel Hashomer and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
8
Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
9
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
10
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
11
University of Otago, Christchurch, New Zealand.
12
Department of Gastroenterology, Faculty of Medicine and Health, Orebro University, Orebro, Sweden.
13
Department of Medicine and Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada. Electronic address: ggkaplan@ucalgary.ca.

Abstract

BACKGROUND:

Hospitalisation rates for inflammatory bowel disease (IBD) vary across the world. We aimed to investigate temporal patterns of hospitalisation for IBD in member countries of the Organisation for Economic Co-operation and Development (OECD).

METHODS:

From the OECD database, we assessed IBD-related hospitalisation rates (expressed as annual rates per 100 000 inhabitants) for 34 countries from 1990 to 2016. We calculated mean hospitalisation rates for the period 2010-15 and used joinpoint regression models to calculate average annual percentage changes with 95% CIs.

FINDINGS:

Mean hospitalisation rates for IBD from 2010 to 2015 were highest in North America (eg, 33·9 per 100 000 in the USA), Europe (eg, 72·9 per 100 000 in Austria), and Oceania (eg, 31·5 per 100 000 in Australia). Hospitalisation rates for IBD were stabilising or decreasing over time in many countries in these regions but increasing in others. Countries in Asia and Latin America and the Caribbean had the lowest IBD-related hospitalisation rates but the greatest increases in rates over time. For example, Turkey had an annual hospitalisation rate of 10·8 per 100 000 inhabitants and an average annual percentage change of 10·4% (95% CI 5·2-15·9). Similarly, Chile had an annual hospitalisation rate of 9·0 per 100 000 inhabitants and an average annual percentage change of 5·9% (4·9-7·0).

INTERPRETATION:

Hospitalisation rates for IBD are high in western countries but are typically stabilising or decreasing, whereas rates in many newly industrialised countries are rapidly increasing, which reflects the known increase in IBD prevalence in these countries. Potential explanations for these trends include changes in the epidemiology of IBD, health-care delivery, and infrastructure in these countries, as well as overall country-specific patterns in hospitalisations and differences between countries in data collection methods.

FUNDING:

None.

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