Impact of fatty liver disease on health care utilization and costs in a general population:: A 5-year observation
Impact of fatty liver disease on health care utilization and costs in a general population:: A 5-year observation
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DOI：
10.1053/j.gastro.2007.10.024
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发表时间：
2008-01-01
期刊：
影响因子：
29.4
通讯作者：
Alte, Dietrich
中科院分区：
文献类型：
--
作者：
Baumeister, Sebastian E.;Voelzke, Henry;Alte, Dietrich
背景与目的：脂肪肝疾病在西方世界是一种常见病症。脂肪肝可能进展为脂肪性肝炎和肝硬化。目前尚不清楚脂肪肝疾病是否会导致更高的医疗利用率和费用。
方法：我们使用来自德国波美拉尼亚健康研究（SHIP）的数据，评估脂肪肝疾病与基线和5年时自我报告的医疗利用率和费用之间的关系。SHIP是一项针对波美拉尼亚基线年龄在20至79岁的4310名成年人的普通人群队列研究。脂肪肝疾病定义为肝脏存在高回声模式且血清丙氨酸氨基转移酶（ALT）水平升高。
结果：在多变量分析中，基线和随访测量时，超声显示有脂肪肝且血清ALT水平升高的个体平均每年的总体医疗费用显著更高。例如，在控制合并症的情况下，超声显示有脂肪肝疾病且血清ALT水平升高的受试者在5年随访时总体医疗费用高出26%。分析还表明，糖尿病和心血管疾病可能介导脂肪肝疾病与医疗利用率和费用之间的关系。
结论：旨在尽量减少与脂肪肝疾病相关费用的政策可能需要考虑解决脂肪肝疾病的行为风险因素。
Background & Aims: Fatty liver disease is a common condition in the Western world. Fatty liver may progress to steatohepatitis and cirrhosis. It is not yet known whether fatty liver disease results in higher health care utilization and costs. Methods: We used data from the Study of Health in Pomerania (SHIP), Germany, to assess the relation of fatty liver disease to self-reported health care utilization and costs at baseline and 5 years. The SHIP is a general population cohort study of 4310 adults aged 20 to 79 years at baseline in Pomerania. Fatty liver disease was defined as the presence of a hyperechogenic pattern of the liver and elevated serum alanine aminotransferase (ALT) levels. Results: In multivariable analyses, average annual overall health care costs at baseline and follow-up measurement were significantly higher for individuals with sonographic fatty liver and increased serum ALT levels. For example, controlling for comorbid conditions, subjects with sonographic fatty liver disease and increased serum ALT levels had 26% higher overall health care costs at 5-year follow-up. Analyses also suggest that diabetes and cardiovascular disease might mediate the relation of fatty liver disease and health care utilization and costs. Conclusions: Policies seeking to minimize costs associated with fatty liver disease might want to consider addressing behavioral risk factors of fatty liver disease.