Charges for Alcoholic Cirrhosis Exceed All Other Etiologies of Cirrhosis Combined: A National and State Inpatient Survey Analysis
Charges for Alcoholic Cirrhosis Exceed All Other Etiologies of Cirrhosis Combined: A National and State Inpatient Survey Analysis
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DOI：
10.1007/s10620-019-5471-7
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发表时间：
2019-06-01
影响因子：
3.1
通讯作者：
Bataller, Ramon
中科院分区：
文献类型：
--
作者：
Barritt, A. Sidney;Jiang, Yue;Bataller, Ramon
背景肝硬化患者的住院费用很高。我们旨在研究肝硬化患者住院费用的趋势，以确定医疗支出的驱动因素。我们假设，酒精性肝硬化（AC）是一个显着的贡献者的整体expenditure.MethodsWe进行了回顾性分析的卫生保健利用项目全国住院病人样本数据库2002-2014年（年度横截面数据）和纽约和佛罗里达州住院病人数据库2010-2012年（纵向数据）。成人肝硬化患者被归类为AC与所有其他肝硬化病因相结合。使用普通最小二乘回归模型分析患者特征。采用随机效应模型评估30天再入院率。ResultsIn total，1，240，152例肝硬化患者在2002年至2014年期间入院。其中，567，510例（45.8%）诊断为AC。在此期间，AC的总费用增加了95.7%，占2014年所有住院患者相关费用的59.9%。AC入院的总费用为280亿美元，从2002年的14亿美元增加到2014年的28亿美元。在NIS和SID中，AC患者为年轻、白色和男性。再入院率在30，60，和90天之间AC patients.ConclusionsInpatient费用肝硬化护理高，并不断增加。与酒精相关的肝病占这些费用的一半以上，并且由同一患者的入院和再入院数量驱动。有效的酒精成瘾治疗可能是最具成本效益的方式，大大减少住院肝硬化护理费用。
BackgroundInpatient charges for patients with cirrhosis are substantial. We aimed to examine trends in inpatient charges among patients with cirrhosis to determine the drivers of healthcare expenditures. We hypothesized that alcoholic cirrhosis (AC) was a significant contributor to overall expense.MethodsWe performed a retrospective analysis of the Health Care Utilization Project Nationwide Inpatient Sample Database 2002-2014 (annual cross-sectional data) and New York and Florida State Inpatient Databases 2010-2012 (longitudinal data). Adult patients with cirrhosis of the liver were categorized as AC versus all other etiologies of cirrhosis combined. Patient characteristics were analyzed using ordinary least squares regression modeling. A random effects model was used to evaluate 30-day readmissions.ResultsIn total, 1,240,152 patients with cirrhosis were admitted between 2002 and 2014. Of these, 567,510 (45.8%) had a diagnosis of AC. Total charges for AC increased by 95.7% over the time period, accounting for 59.9% of all inpatient cirrhosis-related charges in 2014. Total aggregate charges for AC admissions were $28 billion and increased from $1.4B in 2002 to $2.8B by 2014. In the NIS and SID, patients with AC were younger, white and male. Readmission rates at 30, 60, and 90days were all higher among AC patients.ConclusionsInpatient charges for cirrhosis care are high and increasing. Alcohol-related liver disease accounts for more than half of these charges and is driven by sheer volume of admissions and readmissions of the same patients. Effective alcohol addictions therapy may be the most cost-effective way to substantially reduce inpatient cirrhosis care expenditures.