Acute Communicable Disease Control, Los Angeles County Department of Public Health, Los Angeles, CA, USA.
J Viral Hepat. 2013 Sep;20(9):628-37. doi: 10.1111/jvh.12086. Epub 2013 Mar 20.
Morbidity and mortality due to hepatitis C (HCV) infection are rising in the United States as the highest risk cohort (those born between 1945 and 1965) ages. It is important for governments and healthcare providers to have timely, readily obtainable data to estimate the burden of HCV locally. Demographic factors, hospital charges and comorbid conditions were summarized for Los Angeles County (LAC) residents who had at least one hospitalization in California during 2007-2009 with HCV as a primary or secondary diagnosis using statewide hospital discharge data. Logistic regression was used to estimate odds ratios for factors associated with dying during hospitalization. A total of 19 907 unique patients were hospitalized with HCV during the 3-year study period; 63.0% were aged 45-65 years; 1874 (9.4%) died. Hospitalizations for HCV doubled during this time period. Total charges for hospitalizations for which HCV was coded as the principal diagnosis increased from $18 million to $58 million, with over 70% charged to government sources. After adjusting for demographic factors, human immunodeficiency virus (HIV) and hepatitis B (HBV), current alcohol abuse and kidney disease were associated with dying during hospitalization. Based on statewide hospital discharge data, morbidity and mortality from HCV infections increased in LAC from 2007-2009, and pose an economic burden to government. To lower mortality risk, HCV patients should be referred for follow-up. The expected increase in HCV hospitalizations as infected patients' age poses an increasing burden to healthcare systems.
美国因丙型肝炎(HCV)感染导致的发病率和死亡率随着高危人群(1945 年至 1965 年出生的人群)年龄的增长而上升。政府和医疗保健提供者及时获得可用于当地估计 HCV 负担的数据非常重要。使用全州医院出院数据,对 2007-2009 年期间在加利福尼亚州至少有一次住院治疗且 HCV 为主要或次要诊断的洛杉矶县(LAC)居民的人口统计学因素、住院费用和合并症进行了总结。使用逻辑回归估计与住院期间死亡相关的因素的优势比。在 3 年的研究期间,共有 19907 名 HCV 患者住院治疗;63.0%的患者年龄在 45-65 岁之间;1874 人(9.4%)死亡。在此期间,HCV 的住院治疗增加了一倍。HCV 被编码为主诊断的住院费用从 1800 万美元增加到 5800 万美元,超过 70%的费用由政府承担。在调整人口统计学因素、人类免疫缺陷病毒(HIV)和乙型肝炎(HBV)、当前酗酒和肾脏疾病后,住院期间发生死亡与酒精滥用和肾脏疾病有关。基于全州医院出院数据,LAC 地区 2007-2009 年 HCV 感染的发病率和死亡率有所上升,给政府带来了经济负担。为降低死亡率风险,应将 HCV 患者转介进行后续治疗。随着感染患者年龄的增长,预计 HCV 住院人数将增加,这将给医疗系统带来越来越大的负担。