Comparative Analysis of Hospital Admissions and Costs for Psoriatic Disease, Inflammatory Bowel Disease, and Both Conditions in Newfoundland – A JANL-HIP Study

Objectives The economic burden of immune-mediated diseases (IMDs) is a significant concern in healthcare, particularly in patients who present with multiple conditions. This study aims to evaluate the admission rates and hospitalization costs associated with patients with psoriatic disease (PsD) alone, inflammatory bowel disease (IBD) alone, and those with both conditions. Methods A retrospective analysis was conducted using data from the Newfoundland and Labrador Centre for Health Information (NLCHI) spanning from 2009 to 2019. Patients diagnosed with PsD were identified using the ICD-9 code 696 and matched with a control group of approximately 75,500 individuals who did not have PsD. From this cohort of around 100,000 patients, those with IBD were identified using ICD-9 codes 555 for Crohn’s disease (CD) and 556 for ulcerative colitis (UC). Data on the number of hospital admissions and total hospitalization costs were collected from the NLCHI database. Results A total of 15,100 patients were identified with PsD, and 2,800 patients had IBD. Among these cohorts, 14,368 had PsD alone, 2,068 had IBD alone, and 732 had both conditions. Thus, 4.8% of PsD patients were also diagnosed with IBD, comprising 525 patients (3.4%) with CD and 207 patient (1.4%) with UC. The mean number of admissions for patients with both IMIDs was significantly greater at 6.08 over a ten-year period, compared to 3.09 for those with PsD alone (p < 0.0001) and 5.04 for those with IBD alone (p < 0.001). The total hospitalization costs over 10 years for patients with both conditions amounted to $21,814, significantly higher than the $10,742 for PsD alone (p < 0.001), and numerically, though not statistically, higher than the $17,767 for IBD alone (p = 0.09). Similar numerical trends were observed in hospitalizations primarily due to cardiovascular-related events, with costs for both diseases at $2,476 compared to $1,622 for PsD alone and $1,987 for IBD alone. For mental health-related hospitalizations, the cost was $3,931 for both conditions compared to $1,886 for PsD alone and $3,560 for IBD alone. Conclusion These findings highlight the necessity for targeted healthcare strategies that address the complexities of managing multiple IMDs. By focusing on integrated care approaches and efficient resource allocation, healthcare systems can better support patients with these overlapping conditions, ultimately reducing the economic burden and improving patient outcomes.