Cost-effectiveness of alcohol use treatments in patients with alcohol-related cirrhosis

Avanceña, Anton L. V.; Miller, Nicholas; Uttal, Sarah; Hutton, David; Mellinger, Jessica L.

doi:10.1016/j.jhep.2020.12.004

Cited by 29 publications

(32 citation statements)

References 42 publications

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“…Previous reports have suggested that effective alcohol use disorder interventions can help reduce costs related to inpatient cirrhosis management[ 13 ]. Treatments that have been proven to be cost-effective and in some cases cost-saving for ALC include one-on-one physician counselling and medication-assisted therapies[ 15 ]. These have been shown to improve outcomes in patients with compensated ALC[ 15 ].…”

Section: Discussionmentioning

confidence: 99%

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Trends of alcoholic liver cirrhosis readmissions from 2010 to 2018: Rates and healthcare burden associated with readmissions

Kichloo¹,

El-Amir²,

Dahiya³

et al. 2021

WJH

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BACKGROUND Alcoholic liver cirrhosis (ALC) is a chronic liver disease with varying disease severity. Readmissions of ALC are associated with poor outcomes. AIM To identify and assess trends of readmissions for ALC over an eight-year period. METHODS This retrospective interrupted trend study analysed 30-d readmissions of ALC in the United States from 2010 to 2018 using the National Readmissions Database. Hospitalization for ALC was the reason for index admission obtained using the International Classification of Diseases codes (571.2 and K70.3X). Biodemographic characteristics and hospitalization trends were highlighted over time. A multivariate regression analysis model was used to calculate the trend for risk-adjusted odds of 30-d all-cause ALC readmissions, ALC specific readmission rate, ALC readmission proportion, inpatient mortality, mean length of stay (LOS) and mean total hospital cost (THC) following adjustments for age, gender, grouped Charlson Comorbidity Index, insurance, mean household income, and hospital characteristics. RESULTS There was a trend towards increasing total 30-d readmissions of ALC from 7660 in 2010 to 15085 in 2018 ( P < 0.001). Patients readmitted for ALC were noted to have an increasing comorbidity burden over time. We noted a rise in the risk-adjusted 30-d all-cause readmission of ALC from 24.9% in 2010 to 29.9% in 2018 ( P < 0.001). ALC-specific readmission rate increased from 6.3% in 2010 to 8.4% in 2018 ( P < 0.001) while ALC readmission proportion increased from 31.4% in 2010 to 36.3% in 2018 ( P < 0.001). Inpatient mortality for 30-d readmissions of ALC declined from 10.5% in 2010 to 8.2% in 2018 ( P = 0.0079). However, there was a trend towards increasing LOS from 5.6 d in 2010 to 6.3 d in 2018 ( P < 0.001) and increasing THC from 13790 dollars in 2010 to 17150 dollars in 2018 ( P < 0.001). The total days of hospital stay attributable to 30-d readmissions of ALC increased by 119.2% while the total attributable hospital costs increased by 149% by the end of 2018. CONCLUSION There was an increase in the 30-d readmission rate and comorbidity burden for ALC; however, inpatient mortality declined. Additionally, there was a trend towards increasing LOS and THC for these readmissions.

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Section: Discussionmentioning

confidence: 99%

“…Treatments that have been proven to be cost-effective and in some cases cost-saving for ALC include one-on-one physician counselling and medication-assisted therapies[ 15 ]. These have been shown to improve outcomes in patients with compensated ALC[ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Trends of alcoholic liver cirrhosis readmissions from 2010 to 2018: Rates and healthcare burden associated with readmissions

Kichloo¹,

El-Amir²,

Dahiya³

et al. 2021

WJH

View full text Add to dashboard Cite

show abstract

“…For patients with ALD, abstinence, or decreased consumption, is essential to reducing the likelihood of further liver injury and increasing the chances of survival [ 1 , 23 ]. Furthermore, receipt of addiction treatment among patients with ALD is cost-effective, associated with lower rates of hepatic decompensation and mortality [ 24 , 25 ]. Among patients with alcohol use disorder who undergo liver transplantation, establishment or continuation of addiction treatment after transplantation in order to support abstinence from alcohol is recommended [ 26 ].…”

Section: How Gastroenterologists and Hepatologists Can Impact The Pub...mentioning

confidence: 99%

Bridging the Gap: Dual Fellowship Training in Addiction Medicine and Digestive Diseases

Haque

Fiellin

2022

Dig Dis Sci

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“…Recent literature has shown that alcohol-associated liver disease clinics are viable and effective [8]. Furthermore, providing addiction treatment is not only cost-effective, but also lowers the rates of hepatic decompensation and mortality [9][10][11]. For those who are compliant prior to transplantation, ongoing treatment of addiction and mental health comorbidities is essential for the long-term health of the recipient.…”

mentioning

confidence: 99%

Addiction Prescription: A Bridge Between Addiction Medicine and Digestive Diseases

et al. 2022

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Cost-effectiveness of alcohol use treatments in patients with alcohol-related cirrhosis

Cited by 29 publications

References 42 publications

Trends of alcoholic liver cirrhosis readmissions from 2010 to 2018: Rates and healthcare burden associated with readmissions

Trends of alcoholic liver cirrhosis readmissions from 2010 to 2018: Rates and healthcare burden associated with readmissions

Bridging the Gap: Dual Fellowship Training in Addiction Medicine and Digestive Diseases

Addiction Prescription: A Bridge Between Addiction Medicine and Digestive Diseases

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