Introduction: Peptic ulcer disease (PUD) is a common cause of gastrointestinal-related hospitalizations. However, the association between sociodemographic characteristics and PUD-related readmission remains unclear. We aimed to determine whether the risk of 30-day readmission among patients with PUD varies by patient- and county-level sociodemographic and clinical variables.
Methods: We used data from the Florida State Inpatient Database (4th quarter of 2015 to 3rd quarter of 2019) to identify patients aged 18-85 who underwent esophagogastroduodenoscopy (EGD) during an index admission for PUD. Patient- and county-level sociodemographic variables were extracted. The primary outcome was 30-day readmission after the index admission for PUD. Descriptive comparisons of continuous and categorical variables were analyzed using student’s t-tests and chi-square tests, respectively. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) for 30-day readmissions.
Results: Among 8803 index admissions for PUD, 1439 (17.9%) readmissions occurred within 30 days. Readmission rates differed by race, primary payer, and length of stay but not sex, rural/urban residential location, median household income by zip code, or comorbidities. Index admission length of stay was longer for patients that were readmitted versus not readmitted (median 5 versus 4 days, p < 0.001). Compared to White patients, readmission was less likely among individuals who identified as Black (OR=0.79, 95% CI 0.66 – 0.95) or Hispanic (OR=0.72, 95% CI 0.59 – 0.89), after accounting for other patient- and county-level variables. Compared to Medicare beneficiaries, readmission was less likely among patients with private insurance (OR = 0.69, 95% CI 0.57 – 0.83) or self-pay (OR = 0.57; 95% CI 0.43 – 0.75).
Discussion: In the state of Florida, White patients and Medicare beneficiaries were more likely to be readmitted, after accounting for sociodemographic and clinical factors. These results may indicate that White patients and those with Medicare were more likely to receive optimal care.
