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Increasing Economic Burden in Hospitalized Patients With Cirrhosis: Analysis of a National Database

The prevalence of cirrhosis is increasing despite advances in therapeutics, and it remains an expensive medical condition. Studies examining the healthcare burden of inpatient cirrhosis-related care regardless of etiology, stage, or severity are lacking. This study aims to describe the current drive...

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Autores principales: Desai, Archita P., Mohan, Prashanthinie, Nokes, Brandon, Sheth, Deekksha, Knapp, Shannon, Boustani, Malaz, Chalasani, Naga, Fallon, Michael B., Calhoun, Elizabeth A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708673/
https://www.ncbi.nlm.nih.gov/pubmed/31343469
http://dx.doi.org/10.14309/ctg.0000000000000062
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author Desai, Archita P.
Mohan, Prashanthinie
Nokes, Brandon
Sheth, Deekksha
Knapp, Shannon
Boustani, Malaz
Chalasani, Naga
Fallon, Michael B.
Calhoun, Elizabeth A.
author_facet Desai, Archita P.
Mohan, Prashanthinie
Nokes, Brandon
Sheth, Deekksha
Knapp, Shannon
Boustani, Malaz
Chalasani, Naga
Fallon, Michael B.
Calhoun, Elizabeth A.
author_sort Desai, Archita P.
collection PubMed
description The prevalence of cirrhosis is increasing despite advances in therapeutics, and it remains an expensive medical condition. Studies examining the healthcare burden of inpatient cirrhosis-related care regardless of etiology, stage, or severity are lacking. This study aims to describe the current drivers of cost, length of stay (LOS), and mortality in hospitalized patients with cirrhosis. METHODS: Using the National Inpatient Sample (NIS) data from 2008 to 2014, we categorized admissions into decompensated cirrhosis (DC), compensated cirrhosis (CC), and NIS without cirrhosis. Descriptive statistics and regression analysis were used to analyze the association between patient characteristics, comorbidities, complications, and procedures with costs, LOS, and mortality in each group. RESULTS: The hospitalization costs for patients with cirrhosis increased 30.2% from 2008 to 2014 to $7.37 billion. Cirrhosis admissions increased by 36% and 24% in the DC and CC groups, respectively, compared with 7.7% decrease in the NIS without cirrhosis group. DC admissions contributed to 58.6% of total cirrhotic admissions by 2014. Procedures increased costs in both DC and CC groups by 15%–152%, with mechanical ventilation being associated with high cost increase and mortality increase. Complications are also key drivers of costs and LOS, with renal and infectious complications being associated with the highest increases in the DC group and infections and nonportal hypertensive gastrointestinal bleeding for the CC group. DISCUSSION: Economic burden of hospitalized patients with cirrhosis is increasing with more admissions and longer LOS in DC and CC groups. Important drivers include procedures and portal hypertensive and nonportal hypertensive complications.
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spelling pubmed-67086732019-10-10 Increasing Economic Burden in Hospitalized Patients With Cirrhosis: Analysis of a National Database Desai, Archita P. Mohan, Prashanthinie Nokes, Brandon Sheth, Deekksha Knapp, Shannon Boustani, Malaz Chalasani, Naga Fallon, Michael B. Calhoun, Elizabeth A. Clin Transl Gastroenterol Article The prevalence of cirrhosis is increasing despite advances in therapeutics, and it remains an expensive medical condition. Studies examining the healthcare burden of inpatient cirrhosis-related care regardless of etiology, stage, or severity are lacking. This study aims to describe the current drivers of cost, length of stay (LOS), and mortality in hospitalized patients with cirrhosis. METHODS: Using the National Inpatient Sample (NIS) data from 2008 to 2014, we categorized admissions into decompensated cirrhosis (DC), compensated cirrhosis (CC), and NIS without cirrhosis. Descriptive statistics and regression analysis were used to analyze the association between patient characteristics, comorbidities, complications, and procedures with costs, LOS, and mortality in each group. RESULTS: The hospitalization costs for patients with cirrhosis increased 30.2% from 2008 to 2014 to $7.37 billion. Cirrhosis admissions increased by 36% and 24% in the DC and CC groups, respectively, compared with 7.7% decrease in the NIS without cirrhosis group. DC admissions contributed to 58.6% of total cirrhotic admissions by 2014. Procedures increased costs in both DC and CC groups by 15%–152%, with mechanical ventilation being associated with high cost increase and mortality increase. Complications are also key drivers of costs and LOS, with renal and infectious complications being associated with the highest increases in the DC group and infections and nonportal hypertensive gastrointestinal bleeding for the CC group. DISCUSSION: Economic burden of hospitalized patients with cirrhosis is increasing with more admissions and longer LOS in DC and CC groups. Important drivers include procedures and portal hypertensive and nonportal hypertensive complications. Wolters Kluwer 2019-07-23 /pmc/articles/PMC6708673/ /pubmed/31343469 http://dx.doi.org/10.14309/ctg.0000000000000062 Text en © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Article
Desai, Archita P.
Mohan, Prashanthinie
Nokes, Brandon
Sheth, Deekksha
Knapp, Shannon
Boustani, Malaz
Chalasani, Naga
Fallon, Michael B.
Calhoun, Elizabeth A.
Increasing Economic Burden in Hospitalized Patients With Cirrhosis: Analysis of a National Database
title Increasing Economic Burden in Hospitalized Patients With Cirrhosis: Analysis of a National Database
title_full Increasing Economic Burden in Hospitalized Patients With Cirrhosis: Analysis of a National Database
title_fullStr Increasing Economic Burden in Hospitalized Patients With Cirrhosis: Analysis of a National Database
title_full_unstemmed Increasing Economic Burden in Hospitalized Patients With Cirrhosis: Analysis of a National Database
title_short Increasing Economic Burden in Hospitalized Patients With Cirrhosis: Analysis of a National Database
title_sort increasing economic burden in hospitalized patients with cirrhosis: analysis of a national database
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708673/
https://www.ncbi.nlm.nih.gov/pubmed/31343469
http://dx.doi.org/10.14309/ctg.0000000000000062
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