P1287 Comparative Analysis of IBD Management: Hospital Versus Community-based Care
A Israel, K Sharif, A LahatAbstract
Background
Our study aimed to compare disease characteristics, medication utilization, procedures performed, and hospitalizations between IBD patients treated in hospital and community settings using the Leumit Health Service database.
Methods
A retrospective cohort study was conducted using data from the Leumit Health Service, comprising 3020 patients diagnosed with IBD fBetween 2010 -2019. Patients were divided based on primary care setting: hospital-based or community-based. Data included demographic characteristics, disease type, medication usage, procedures, and outcomes.
Results
Overall 3020 patients were included, of them 1627 ( 54%) were community treated, and 1741 (57%) suffered from CD. Hospital-treated patients were significantly younger (49.4 ± 18.4 vs 40.4 ± 18.7,p<0.001 ), had higher rates of Crohn’s disease (45.9 % vs 71.4 %, p<0.001), exhibited higher inflammatory markers (calprotectin 768 ± 2182 vs 1305 ± 2526, p <0.001) , lower albumin ( 4.23 ± 0.27vs 4.12 ± 0.32, p<0.001)and Hemoglobin levels (13.4 ± 1.6 vs 12.9 ± 1.6, p <0.001) , and lower BMI (26.2 ± 5.3 vs 24.6 ± 5.6, p<0.001) compared to community-treated patients. Hospital-treated patients had more endoscopic procedures, higher medication utilization rates, shorter treatment durations, and increased hospitalizations occurrence (12.1 % vs 23.6 %, p<0.001) , length (0.67 ± 3.34 vs 1.45 ± 5.88, p<0.001), and colectomies (4.73 % vs 15.8 %,p<0.001). Table 1 displays emergency room (ER) visits, hospitalizations and colectomy among study groups,and Figure 1 displays medical treatments among study groups.
Conclusion
Hospital-based care is associated with more aggressive disease and intensive interventions, while community-based care may reflect milder disease and conservative management. Integrating specialized care models and personalized approaches across settings can optimize patient outcomes and healthcare delivery for IBD management.