OBJECTIVE: Hepatitis C virus (HCV) is a common blood-borne infection in the US. Over time, patients with chronic HCV can encounter serious complications that impose a significant cost burden to third party payers. In this study, we generated national estimates of inpatient costs, length of stay (LOS), and probability of death associated with four major chronic HCV-related complications.
METHODS: Discharge data for patients with chronic HCV (ICD-9 070.44, 070.54, 070.70, or 070.71) were analyzed using the 2005 HCUP Nationwide Inpatient Sample. Discharges related to ascites, variceal bleeding, hepatic encephalopathy, and hepatocellular carcinoma (hepatoma) were identified using relevant ICD-9 diagnosis codes. Weighted estimates of costs, LOS, and probability of death were calculated for stays related to these complications.
RESULTS: We identified a weighted total of 275,737 chronic HCV-related discharges. Approximately 11.5% of these discharges were for ascites and 5.6% were for hepatic encephalopathy. Admissions for variceal bleeding and hepatoma were less common at 0.3% and 2.8%, respectively. Hepatoma, however, was associated with the highest total inpatient costs ($17,609) and LOS (6.3 days). The probability of death from hepatoma was 11%. Patients had 7.3 inpatient days on average for ascites with a cost per day of $2125 and total inpatient cost of $14,858. The probability of death from ascites was 9%. The average number of inpatient days for hepatic encephalopathy was 7 days with a cost per day of $1936, total inpatient cost of $13,380, and probability of death of 11%. Patients with variceal bleeding had the lowest inpatient costs ($12,128) and LOS (5.4 days). The probability of death from variceal bleeding (8%) was lower compared to the other complications.
CONCLUSION: Advanced chronic HCV can lead to serious and costly complications. Efforts to improve HCV treatment may help slow disease progression and thus result in cost savings from avoided complications.
