Increasing prevalence of cirrhosis among insured adults in the United States, 2012-2018.
<h4>Background</h4>Liver cirrhosis is a chronic disease that is known as a "silent killer" and its true prevalence is difficult to describe. It is imperative to accurately characterize the prevalence of cirrhosis because of its increasing healthcare burden.<h4>Methods<...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2024-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0298887&type=printable |
| _version_ | 1797238414131593216 |
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| author | Daniela P Ladner Michael Gmeiner Bima J Hasjim Nikhilesh Mazumder Raymond Kang Emily Parker John Stephen Praneet Polineni Anna Chorniy Lihui Zhao Lisa B VanWagner Ronald T Ackermann Charles F Manski |
| author_facet | Daniela P Ladner Michael Gmeiner Bima J Hasjim Nikhilesh Mazumder Raymond Kang Emily Parker John Stephen Praneet Polineni Anna Chorniy Lihui Zhao Lisa B VanWagner Ronald T Ackermann Charles F Manski |
| author_sort | Daniela P Ladner |
| collection | DOAJ |
| description | <h4>Background</h4>Liver cirrhosis is a chronic disease that is known as a "silent killer" and its true prevalence is difficult to describe. It is imperative to accurately characterize the prevalence of cirrhosis because of its increasing healthcare burden.<h4>Methods</h4>In this retrospective cohort study, trends in cirrhosis prevalence were evaluated using administrative data from one of the largest national health insurance providers in the US. (2011-2018). Enrolled adult (≥18-years-old) patients with cirrhosis defined by ICD-9 and ICD-10 were included in the study. The primary outcome measured in the study was the prevalence of cirrhosis 2011-2018.<h4>Results</h4>Among the 371,482 patients with cirrhosis, the mean age was 62.2 (±13.7) years; 53.3% had commercial insurance and 46.4% had Medicare Advantage. The most frequent cirrhosis etiologies were alcohol-related (26.0%), NASH (20.9%) and HCV (20.0%). Mean time of follow-up was 725 (±732.3) days. The observed cirrhosis prevalence was 0.71% in 2018, a 2-fold increase from 2012 (0.34%). The highest prevalence observed was among patients with Medicare Advantage insurance (1.67%) in 2018. Prevalence increased in each US. state, with Southern states having the most rapid rise (2.3-fold). The most significant increases were observed in patients with NASH (3.9-fold) and alcohol-related (2-fold) cirrhosis.<h4>Conclusion</h4>Between 2012-2018, the prevalence of liver cirrhosis doubled among insured patients. Alcohol-related and NASH cirrhosis were the most significant contributors to this increase. Patients living in the South, and those insured by Medicare Advantage also have disproportionately higher prevalence of cirrhosis. Public health interventions are important to mitigate this concerning trajectory of strain to the health system. |
| first_indexed | 2024-03-07T16:28:45Z |
| format | Article |
| id | doaj.art-a09c8f59cebe4842a21a8cfcdca774c7 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-24T17:35:15Z |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-a09c8f59cebe4842a21a8cfcdca774c72024-03-28T05:35:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01192e029888710.1371/journal.pone.0298887Increasing prevalence of cirrhosis among insured adults in the United States, 2012-2018.Daniela P LadnerMichael GmeinerBima J HasjimNikhilesh MazumderRaymond KangEmily ParkerJohn StephenPraneet PolineniAnna ChorniyLihui ZhaoLisa B VanWagnerRonald T AckermannCharles F Manski<h4>Background</h4>Liver cirrhosis is a chronic disease that is known as a "silent killer" and its true prevalence is difficult to describe. It is imperative to accurately characterize the prevalence of cirrhosis because of its increasing healthcare burden.<h4>Methods</h4>In this retrospective cohort study, trends in cirrhosis prevalence were evaluated using administrative data from one of the largest national health insurance providers in the US. (2011-2018). Enrolled adult (≥18-years-old) patients with cirrhosis defined by ICD-9 and ICD-10 were included in the study. The primary outcome measured in the study was the prevalence of cirrhosis 2011-2018.<h4>Results</h4>Among the 371,482 patients with cirrhosis, the mean age was 62.2 (±13.7) years; 53.3% had commercial insurance and 46.4% had Medicare Advantage. The most frequent cirrhosis etiologies were alcohol-related (26.0%), NASH (20.9%) and HCV (20.0%). Mean time of follow-up was 725 (±732.3) days. The observed cirrhosis prevalence was 0.71% in 2018, a 2-fold increase from 2012 (0.34%). The highest prevalence observed was among patients with Medicare Advantage insurance (1.67%) in 2018. Prevalence increased in each US. state, with Southern states having the most rapid rise (2.3-fold). The most significant increases were observed in patients with NASH (3.9-fold) and alcohol-related (2-fold) cirrhosis.<h4>Conclusion</h4>Between 2012-2018, the prevalence of liver cirrhosis doubled among insured patients. Alcohol-related and NASH cirrhosis were the most significant contributors to this increase. Patients living in the South, and those insured by Medicare Advantage also have disproportionately higher prevalence of cirrhosis. Public health interventions are important to mitigate this concerning trajectory of strain to the health system.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0298887&type=printable |
| spellingShingle | Daniela P Ladner Michael Gmeiner Bima J Hasjim Nikhilesh Mazumder Raymond Kang Emily Parker John Stephen Praneet Polineni Anna Chorniy Lihui Zhao Lisa B VanWagner Ronald T Ackermann Charles F Manski Increasing prevalence of cirrhosis among insured adults in the United States, 2012-2018. PLoS ONE |
| title | Increasing prevalence of cirrhosis among insured adults in the United States, 2012-2018. |
| title_full | Increasing prevalence of cirrhosis among insured adults in the United States, 2012-2018. |
| title_fullStr | Increasing prevalence of cirrhosis among insured adults in the United States, 2012-2018. |
| title_full_unstemmed | Increasing prevalence of cirrhosis among insured adults in the United States, 2012-2018. |
| title_short | Increasing prevalence of cirrhosis among insured adults in the United States, 2012-2018. |
| title_sort | increasing prevalence of cirrhosis among insured adults in the united states 2012 2018 |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0298887&type=printable |
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