Direct and Indirect Economic Burden of Chronic Liver Disease in the United States

Stepanova, Maria; Avila, Leyla de; Afendy, Mariam; Younossi, Issah; Pham, Huong; Cable, Rebecca; Younossi, Zobair M.

doi:10.1016/j.cgh.2016.07.020

Cited by 139 publications

(134 citation statements)

References 32 publications

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“…Cirrhosis has an extensive burden on the healthcare system . In the United States, more than 600 000 people have cirrhosis, and nearly 60 000 die every year because of cirrhosis‐related complications .…”

Section: Introductionmentioning

confidence: 99%

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Nationwide estimates and risk factors of hospital readmission in patients with cirrhosis in the United States

Shaheen

Nguyen

Congly

et al. 2019

Liver International

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Background The burden of cirrhosis on the healthcare system is substantial and growing. Our objectives were to estimate the readmission rates and hospitalization costs as well as to identify risk factors for 90‐day readmission in patients with cirrhosis. Methods We conducted a weighted analysis of the 2014 Nationwide Readmission Database to identify adult patients with cirrhosis‐related complications in the United States and assessed readmission rates at 30, 60 and 90 days post‐index hospitalization. Predictors of 90‐day readmissions were identified using weighted regression models adjusting for patient and hospital characteristics; the national estimate of hospitalization costs was also calculated. Results Of the 58 954 patients admitted with cirrhosis‐related complications in 2014, 14 910 (25%) were readmitted within 90 days because of cirrhosis‐related complications. The main causes of readmission were ascites (56%), hepatic encephalopathy (47%) and bleeding oesophageal varices (9%). Independent predictors of 90‐day readmissions were male sex (adjusted OR [aOR]: 1.08, 95% CI, 1.04‐1.13), age <60 (aOR: 1.27, 95% CI, 1.22‐1.32), privately insured (aOR: 0.74, 95% CI, 0.70‐0.77), having ≥3 comorbid conditions (aOR: 1.27, 95% CI, 1.14‐1.42) and being discharged against medical advice (aOR: 1.41, 95% CI, 1.25‐1.59). The weighted cumulative national cost estimate of the index admission was $1.8 billion, compared to $0.5 billion for readmission. Conclusions A quarter of patients admitted with cirrhosis‐related complications were readmitted within 90 days, representing a significant economic burden related to readmission of this population. Interventions and resource allocations to reduce readmission rates among cirrhotic patients is critical.

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Section: Introductionmentioning

confidence: 99%

“…In the United States, more than 600 000 people have cirrhosis, and nearly 60 000 die every year because of cirrhosis‐related complications . Recent studies have shown morbidity and mortality related to cirrhosis are growing and are expected to peak in the next two decades because of the epidemic of non‐alcoholic fatty liver disease …”

Section: Introductionmentioning

confidence: 99%

Nationwide estimates and risk factors of hospital readmission in patients with cirrhosis in the United States

Shaheen

Nguyen

Congly

et al. 2019

Liver International

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“…The burden of HCV infection on work productivity is largely driven by limited labor force participation among patients with HCV, which results in lost wages and benefits; indeed, low employment rate in patients with HCV (54% vs 62% national) has been confirmed in a recent report from the United States, 92 supported by similar reports from other countries. 73,[93][94][95] Another contributor to that burden is impaired work productivity in patients who are employed; it includes both lost hours of work (absenteeism) and decreased productivity while working (presenteeism).…”

Section: Economic Burden Owing To Work Productivity Losses In Hepatitmentioning

confidence: 61%

Economic Burden of Hepatitis C Infection

Stepanova

Younossi

2017

Clinics in Liver Disease

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“…Five to 7% of patients with cirrhosis will progress from a compensated to decompensated state annually . During this later stage of illness, they experience self‐reported diminishing quality of life and worse general and mental health compared to the general population . The pain and suffering associated with dying with decompensated cirrhosis is comparable to colon and lung cancers…”

Section: Introductionmentioning

confidence: 99%