Thomas Jefferson University Hospital Philadelphia, PA
Brenda French, MD1, Christine Shieh, MD1, Caroline Johnson, MD2; 1Thomas Jefferson University Hospital, Philadelphia, PA; 2Philadelphia Department of Public Health, Philadelphia, PA
Introduction: Older age is a well-known risk factor for development of diverticular disease. Otherwise, demographic data varies significantly between studies. For this reason, we performed an epidemiological assessment of patients hospitalized with diverticular disease in Philadelphia to explore what subpopulation of patients are most vulnerable to developing manifestations requiring hospitalization. Methods: Demographic data including age, race, and gender was collected from 30,688 hospital admissions for diverticular disease in Philadelphia spanning 2002-2018 using inpatient data provided by the Pennsylvania Health Care Cost Containment Council (PHC4). Data from the 2010 US Census was used for comparison to the demographics of the general Philadelphia population. Results: Between 2002 and 2018, diverticular disease was responsible for 30,688 hospital admissions. These hospitalizations accounted for nearly 1% of all hospitalizations (n=3,371,839) in Philadelphia during that time. Patients hospitalized with diverticular disease tend to be older (64.9 ± 16.3) than patients hospitalized with other conditions (55.7 ± 20.4) (p< 0.00001) and are more likely to be female compared to all other hospitalizations (OR=1.09; 95% CI= 1.07-1.12) as well as the general Philadelphia population (OR=1.44; 95% CI=1.41-1.47)(Table 1). Trends from 2002 to 2018 indicate a 41.5% decrease in the number of White individuals and a 19.5% increase in the number of Black individuals admitted for diverticular disease. These changes resulted in a recent shift towards diverticular disease disproportionately affecting Black individuals more than White individuals as of 2014, with a projected increase in this disparity in the coming years (Figure 1). Discussion: Overall, our study found that, recently, individuals hospitalized with diverticular disease in Philadelphia tend to be female and Black. It is also important to note that while management of diverticular disease is shifting to more outpatient care, Black patients have been hospitalized at increasing rates not attributable to population shifts in Philadelphia. This suggests that some groups are not benefiting from this shift towards outpatient management in the same way as that other racial groups are. Once thought to be caused by patient-centric choices, this study shows the etiology of diverticular disease to be more nuanced with clear implications of healthcare disparity at play in its development.
Figure 1. Number of hospitalizations with diverticular disease as primary diagnosis in the Philadelphia area between 2002-2018, categorized by race.
Table 1. Total number, average age (+/- S.D.), and number/percentage female gender of hospitalizations with diverticular disease in the Philadelphia area between 2002-2018 compared to all hospitalizations during that timeframe.
Disclosures: Brenda French indicated no relevant financial relationships. Christine Shieh indicated no relevant financial relationships. Caroline Johnson indicated no relevant financial relationships.