Term of Award

Spring 2026

Degree Name

Doctor of Public Health in Public Health Leadership (Dr.P.H.)

Document Type and Release Option

Dissertation (open access)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

Department

Jiann-Ping Hsu College of Public Health

Committee Chair

Linda Kimsey

Committee Member 1

Kelly Sullivan

Committee Member 2

William Mase

Abstract

Background Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is a chronic gastrointestinal condition affecting over 80,000 children in the United States, with rising incidence and hospitalizations. Purpose This study assessed trends in pediatric IBD-related hospitalizations and examined associations between hospital, stay, and patient characteristics with IBD case complexity and length of stay using HCUP-KID data from 2019 and 2022. Methods A retrospective serial cross-sectional study included hospitalizations for patients 0 - 20 years old with Crohn’s disease or ulcerative colitis in the first three diagnosis fields. ICD-10 codes classified cases as complicated or uncomplicated. Multivariable logistic regression identified predictors of complicated IBD, and negative binomial regression examined factors associated with length of stay. Results Total pediatric IBD hospitalizations decreased from 15,307 in 2019 to 13,211 in 2022 (18.44 vs. 16.02 per 100,000 children, p < 0.0001). Complicated IBD hospitalizations slightly decreased from 6,122 in 2019 to 5,933 in 2022 (7.38 vs. 7.19 per 100,000, p = 0.152). Hospitalizations for both Crohn’s disease and ulcerative colitis decreased (p < 0.001), with complicated Crohn’s disease hospitalizations also decreasing (p = 0.022). Admission to rural hospitals (vs. urban teaching hospitals), admissions in March or December (vs. January), and 2022 hospitalizations (vs. 2019) were associated with higher odds of complicated IBD, whereas female sex (vs. male), ages 0 – 5, 6 – 11, and 18-20 (vs. 12 – 17 years), medium hospital bed size (vs. large) and ulcerative colitis were associated with lower odds. Longer hospital stays were associated with complicated IBD, admission in September (vs. January), age 0 – 5 (vs. 12 – 17), Native American race (vs. White), Medicaid or other insurance (vs. private), and ulcerative colitis, whereas shorter stays were observed for age 18 – 20 (vs. 12 – 17), small hospitals (vs. large) and urban non-teaching or rural hospitals (vs. urban teaching). Conclusion Overall pediatric IBD-related hospitalizations declined between 2019 and 2022, with total hospitalizations decreasing for both Crohn’s disease and ulcerative colitis, and complicated hospitalizations decreasing for Crohn’s disease. Length of stay was influenced by hospital, stay, and patient characteristics, highlighting the importance of targeted interventions and regionalization of care to improve pediatric IBD outcomes.

Research Data and Supplementary Material

No

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Available for download on Friday, December 11, 2026

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