Inpatient healthcare utilisation in patients with alcoholic liver disease: what are the costs and outcomes?
<br/><strong>Background: </strong>Alcoholic liver disease (ALD) carries a significant cost burden and often leads to inpatient care. It is unclear whether inpatient care for ALD is any more costly than admission for other reasons.<br/><strong>Aims: </strong>To com...
| Main Authors: | , , , |
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| Format: | Journal article |
| Language: | English |
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Wiley
2016
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| _version_ | 1826261283099377664 |
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| author | Williamson, KD Gill, MG Andrews, JM Harley, HAJ |
| author_facet | Williamson, KD Gill, MG Andrews, JM Harley, HAJ |
| author_sort | Williamson, KD |
| collection | OXFORD |
| description | <br/><strong>Background: </strong>Alcoholic liver disease (ALD) carries a significant cost burden and often leads to inpatient care. It is unclear whether inpatient care for ALD is any more costly than admission for other reasons.<br/><strong>Aims: </strong>To compare the costs and outcomes of inpatient care for ALD to two groups: a control group of matched cases admitted in the same time frame and people admitted for other chronic liver diseases (CLD).<br/><strong>Methods: </strong>All admissions for ALD and other CLD in a 3‐month period were retrospectively identified. Five randomly identified gender‐ and age‐matched contemporaneously admitted controls were allocated. Length of stay (LoS), mortality, inpatient costs, blood product utilisation and discharge destination were compared.<br/><strong>Results: </strong>Of the 71 admissions due to CLD, ALD was the most frequent cause (53/71, 75%). ALD admissions cost more (median $10 100 vs $5294; P = 0.0012) and had greater LoS (median LoS 7.2 days (interquartile range (IQR) 0.2–40.7)) than controls (2.6 days (IQR 1.1–6.8); P = 0.0001). A larger proportion of the ALD cohort required blood transfusion and had a higher mortality than controls (24.5 vs 6.4%, P = 0.002 and 13.2 vs 0.2%; P < 0.0001 respectively). Self‐discharge was more common in the ALD group (13.2 vs 1.1%, P < 0.0001).<br/><strong>Conclusions: </strong>ALD inpatient hospital admissions have greater median total cost, longer LoS, greater blood product utilisation, higher mortality and greater rate of discharge against medical advice than age‐ and gender‐matched controls. These data emphasise the large inpatient care burden, high mortality and suboptimal engagement in those with ALD, which justifies the more active provision of services for ALD. |
| first_indexed | 2024-03-06T19:19:00Z |
| format | Journal article |
| id | oxford-uuid:19673708-9608-49dc-a17a-f24c80ab7eab |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:19:00Z |
| publishDate | 2016 |
| publisher | Wiley |
| record_format | dspace |
| spelling | oxford-uuid:19673708-9608-49dc-a17a-f24c80ab7eab2022-03-26T10:48:53ZInpatient healthcare utilisation in patients with alcoholic liver disease: what are the costs and outcomes?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:19673708-9608-49dc-a17a-f24c80ab7eabEnglishSymplectic Elements at OxfordWiley2016Williamson, KDGill, MGAndrews, JMHarley, HAJ<br/><strong>Background: </strong>Alcoholic liver disease (ALD) carries a significant cost burden and often leads to inpatient care. It is unclear whether inpatient care for ALD is any more costly than admission for other reasons.<br/><strong>Aims: </strong>To compare the costs and outcomes of inpatient care for ALD to two groups: a control group of matched cases admitted in the same time frame and people admitted for other chronic liver diseases (CLD).<br/><strong>Methods: </strong>All admissions for ALD and other CLD in a 3‐month period were retrospectively identified. Five randomly identified gender‐ and age‐matched contemporaneously admitted controls were allocated. Length of stay (LoS), mortality, inpatient costs, blood product utilisation and discharge destination were compared.<br/><strong>Results: </strong>Of the 71 admissions due to CLD, ALD was the most frequent cause (53/71, 75%). ALD admissions cost more (median $10 100 vs $5294; P = 0.0012) and had greater LoS (median LoS 7.2 days (interquartile range (IQR) 0.2–40.7)) than controls (2.6 days (IQR 1.1–6.8); P = 0.0001). A larger proportion of the ALD cohort required blood transfusion and had a higher mortality than controls (24.5 vs 6.4%, P = 0.002 and 13.2 vs 0.2%; P < 0.0001 respectively). Self‐discharge was more common in the ALD group (13.2 vs 1.1%, P < 0.0001).<br/><strong>Conclusions: </strong>ALD inpatient hospital admissions have greater median total cost, longer LoS, greater blood product utilisation, higher mortality and greater rate of discharge against medical advice than age‐ and gender‐matched controls. These data emphasise the large inpatient care burden, high mortality and suboptimal engagement in those with ALD, which justifies the more active provision of services for ALD. |
| spellingShingle | Williamson, KD Gill, MG Andrews, JM Harley, HAJ Inpatient healthcare utilisation in patients with alcoholic liver disease: what are the costs and outcomes? |
| title | Inpatient healthcare utilisation in patients with alcoholic liver disease: what are the costs and outcomes? |
| title_full | Inpatient healthcare utilisation in patients with alcoholic liver disease: what are the costs and outcomes? |
| title_fullStr | Inpatient healthcare utilisation in patients with alcoholic liver disease: what are the costs and outcomes? |
| title_full_unstemmed | Inpatient healthcare utilisation in patients with alcoholic liver disease: what are the costs and outcomes? |
| title_short | Inpatient healthcare utilisation in patients with alcoholic liver disease: what are the costs and outcomes? |
| title_sort | inpatient healthcare utilisation in patients with alcoholic liver disease what are the costs and outcomes |
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