S2036 Hospitalization in Inflammatory Bowel Disease Is Associated With Substantial Direct and Indirect Costs: A National MEPS-Based Analysis

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). Conclusion: 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.