Inpatient hospital burden of hepatitis C-diagnosed patients with decompensated cirrhosis

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Abstract

Background & Aims: To describe the burden on inpatient hospital resources over time from patients diagnosed with hepatitis C virus (HCV) infection and who have reached the decompensated stage of cirrhosis (DC), as existing estimates of hospital stay in these patients are limited. Methods: A retrospective longitudinal dataset was formed via record-linkage between the national HCV diagnosis database and inpatient/daycase hospitalisation and death registers in Scotland. The study population consisted of HCV-diagnosed patients with a first DC admission in 1996-2013, with follow-up available until 31 May 2014. We investigated and quantified the mean cumulative length of hospital stay, distributions over discharge diagnosis categories, and trends in admission rates. Results: Among our study population (n=1543), we identified 10,179 admissions with any diagnosis post-first DC admission. Between 1996 and 2013 there was a 16-fold rise in annual total admissions (from 112 to 1791) and an 11-fold rise in hospital stay (719 to 8045). When restricting minimum possible follow-up to two years, DC patients (n=1312) had an overall admission rate of 7.3 per person-year, and spent on average 43 days (26 days during first 6 months) in hospital; for all liver-related, liver-related other than HCC/DC, and non-liver related only admissions, this was 39, 14, and 5 days, respectively. Conclusions: HCV-infected DC patients impose a considerable inpatient hospital burden, mostly from DC- and other liver-related admissions, but also from admissions associated with non-liver co-morbidities. Estimates will be useful for monitoring the impact of prevention and treatment, and for computing the cost-effectiveness of new therapies.
Original languageEnglish
Pages (from-to)1402-1410
Number of pages9
JournalLiver International
Volume38
Issue number8
Early online date19 Jan 2018
DOIs
Publication statusPublished - Aug 2018

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Hepatitis C
Inpatients
Fibrosis
Hepacivirus
Length of Stay
Liver Cirrhosis
Liver
Scotland
Virus Diseases
Health Care Costs
Population
Cost-Benefit Analysis
Hospitalization
Databases
Morbidity
Therapeutics

Keywords

  • Scotland
  • hospital stay
  • decompensated cirrhosis
  • hepatitis C virus

Cite this

@article{183117d3f0bc4721be6221124e99ae0f,
title = "Inpatient hospital burden of hepatitis C-diagnosed patients with decompensated cirrhosis",
abstract = "Background & Aims: To describe the burden on inpatient hospital resources over time from patients diagnosed with hepatitis C virus (HCV) infection and who have reached the decompensated stage of cirrhosis (DC), as existing estimates of hospital stay in these patients are limited. Methods: A retrospective longitudinal dataset was formed via record-linkage between the national HCV diagnosis database and inpatient/daycase hospitalisation and death registers in Scotland. The study population consisted of HCV-diagnosed patients with a first DC admission in 1996-2013, with follow-up available until 31 May 2014. We investigated and quantified the mean cumulative length of hospital stay, distributions over discharge diagnosis categories, and trends in admission rates. Results: Among our study population (n=1543), we identified 10,179 admissions with any diagnosis post-first DC admission. Between 1996 and 2013 there was a 16-fold rise in annual total admissions (from 112 to 1791) and an 11-fold rise in hospital stay (719 to 8045). When restricting minimum possible follow-up to two years, DC patients (n=1312) had an overall admission rate of 7.3 per person-year, and spent on average 43 days (26 days during first 6 months) in hospital; for all liver-related, liver-related other than HCC/DC, and non-liver related only admissions, this was 39, 14, and 5 days, respectively. Conclusions: HCV-infected DC patients impose a considerable inpatient hospital burden, mostly from DC- and other liver-related admissions, but also from admissions associated with non-liver co-morbidities. Estimates will be useful for monitoring the impact of prevention and treatment, and for computing the cost-effectiveness of new therapies.",
keywords = "Scotland, hospital stay, decompensated cirrhosis, hepatitis C virus",
author = "McDonald, {Scott A.} and Hamish Innes and Aspinall, {Esther J.} and Hayes, {Peter C.} and Maryam Alavi and Heather Valerio and Goldberg, {David J.} and Hutchinson, {Sharon J.}",
note = "Acceptance in SAN AAM: 12m embargo",
year = "2018",
month = "8",
doi = "10.1111/liv.13681",
language = "English",
volume = "38",
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}

Inpatient hospital burden of hepatitis C-diagnosed patients with decompensated cirrhosis. / McDonald, Scott A.; Innes, Hamish; Aspinall, Esther J.; Hayes, Peter C. ; Alavi, Maryam ; Valerio, Heather; Goldberg, David J.; Hutchinson, Sharon J.

In: Liver International, Vol. 38, No. 8, 08.2018, p. 1402-1410.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Inpatient hospital burden of hepatitis C-diagnosed patients with decompensated cirrhosis

AU - McDonald, Scott A.

AU - Innes, Hamish

AU - Aspinall, Esther J.

AU - Hayes, Peter C.

AU - Alavi, Maryam

AU - Valerio, Heather

AU - Goldberg, David J.

AU - Hutchinson, Sharon J.

N1 - Acceptance in SAN AAM: 12m embargo

PY - 2018/8

Y1 - 2018/8

N2 - Background & Aims: To describe the burden on inpatient hospital resources over time from patients diagnosed with hepatitis C virus (HCV) infection and who have reached the decompensated stage of cirrhosis (DC), as existing estimates of hospital stay in these patients are limited. Methods: A retrospective longitudinal dataset was formed via record-linkage between the national HCV diagnosis database and inpatient/daycase hospitalisation and death registers in Scotland. The study population consisted of HCV-diagnosed patients with a first DC admission in 1996-2013, with follow-up available until 31 May 2014. We investigated and quantified the mean cumulative length of hospital stay, distributions over discharge diagnosis categories, and trends in admission rates. Results: Among our study population (n=1543), we identified 10,179 admissions with any diagnosis post-first DC admission. Between 1996 and 2013 there was a 16-fold rise in annual total admissions (from 112 to 1791) and an 11-fold rise in hospital stay (719 to 8045). When restricting minimum possible follow-up to two years, DC patients (n=1312) had an overall admission rate of 7.3 per person-year, and spent on average 43 days (26 days during first 6 months) in hospital; for all liver-related, liver-related other than HCC/DC, and non-liver related only admissions, this was 39, 14, and 5 days, respectively. Conclusions: HCV-infected DC patients impose a considerable inpatient hospital burden, mostly from DC- and other liver-related admissions, but also from admissions associated with non-liver co-morbidities. Estimates will be useful for monitoring the impact of prevention and treatment, and for computing the cost-effectiveness of new therapies.

AB - Background & Aims: To describe the burden on inpatient hospital resources over time from patients diagnosed with hepatitis C virus (HCV) infection and who have reached the decompensated stage of cirrhosis (DC), as existing estimates of hospital stay in these patients are limited. Methods: A retrospective longitudinal dataset was formed via record-linkage between the national HCV diagnosis database and inpatient/daycase hospitalisation and death registers in Scotland. The study population consisted of HCV-diagnosed patients with a first DC admission in 1996-2013, with follow-up available until 31 May 2014. We investigated and quantified the mean cumulative length of hospital stay, distributions over discharge diagnosis categories, and trends in admission rates. Results: Among our study population (n=1543), we identified 10,179 admissions with any diagnosis post-first DC admission. Between 1996 and 2013 there was a 16-fold rise in annual total admissions (from 112 to 1791) and an 11-fold rise in hospital stay (719 to 8045). When restricting minimum possible follow-up to two years, DC patients (n=1312) had an overall admission rate of 7.3 per person-year, and spent on average 43 days (26 days during first 6 months) in hospital; for all liver-related, liver-related other than HCC/DC, and non-liver related only admissions, this was 39, 14, and 5 days, respectively. Conclusions: HCV-infected DC patients impose a considerable inpatient hospital burden, mostly from DC- and other liver-related admissions, but also from admissions associated with non-liver co-morbidities. Estimates will be useful for monitoring the impact of prevention and treatment, and for computing the cost-effectiveness of new therapies.

KW - Scotland

KW - hospital stay

KW - decompensated cirrhosis

KW - hepatitis C virus

U2 - 10.1111/liv.13681

DO - 10.1111/liv.13681

M3 - Article

VL - 38

SP - 1402

EP - 1410

IS - 8

ER -