271452 Hospitalization costs associated with liver disease, liver cancer and liver transplants for patients infected with hepatitis B or hepatitis C, California 2010

Wednesday, October 31, 2012 : 12:50 PM - 1:05 PM

Kathleen Winter, MPH , Immunization Branch, California Department of Public Health, Richmond, CA
Rachel McLean, MPH , STD Control Branch, California Department of Public Health, Richmond, CA
Kathleen Harriman, PhD, MPH, RN , Immunization Branch, California Department of Public Health, Richmond, CA
Background: Hepatitis B (HBV) and hepatitis C (HCV) viruses are two of the world's most common and serious infectious diseases and place a significant burden on healthcare resources. Approximately 20% of HCV-infected and 15-40% of HBV-infected persons will develop liver cirrhosis, liver disease or hepatocellular carcinoma.

Methods: The California Office of Statewide Health Planning and Development Patient Discharge Database comprises records for each inpatient discharged from a California licensed hospital each year. The following ICD-9-CM diagnosis and procedure codes were used to identify patients in this dataset hospitalized with HBV (070.20-070.39, 070.42-070.42, 070.52) or HCV (070.70-070.79, 070.40, 07044, 07051, 07054) and with liver disease (570.00 - 573.99), liver cancer (155.00-156.99), or liver transplant (505.0-505.9). Total inpatient charges based on the hospital's full established rates of services rendered during the admission before contractual adjustments were calculated and stratified by payer.

Results: In 2010, there were more than 30,000 hospitalizations in California for liver disease, liver cancer, or liver transplant-related treatments in patients infected with HBV or HCV. Over $2.3 billion was charged for more than 206,000 hospitalization days, including >$819,000,000 charged to Medicare and >$821,000,000 charged to Medicaid. The majority of these costs ($2.1 billion) were related to patients infected with HCV.

Discussion: Liver disease, cancer and transplant-related hospitalization costs in California among patients infected with HBV or HCV are substantial. The majority of these costs are covered by tax-supported public health insurers. Patient screening and early treatments should be considered public health priorities to reduce end-stage liver disease complications related to these infectious diseases.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related public policy

Learning Objectives:
Estimate the direct hospitalization costs of liver disease-related inpatient stays in patients infected with hepatitis B and/or hepatitis C viruses in California.

Keywords: Hepatitis B, Hepatitis C

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a supervising epidemiologist in the Vaccine-preventable Disease Surveillance and Epidemiology Section of the California Department of Public Health Immunization Branch for over 5 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5177.0: Viral Hepatitis