Department of Digestive Medicine, CHU Estaing, Clermont-Ferrand, France; Unité mixte de recherche Université d'Auvergne CNRS 6284, France.
Department of Geriatric Medicine, Centre Hospitalier du Pays d'Aix, Aix-en-Provence, France.
Clin Res Hepatol Gastroenterol. 2016 Jun;40(3):340-348. doi: 10.1016/j.clinre.2015.08.006. Epub 2015 Nov 3.
This retrospective hospital database analysis aimed to determine the burden and cost of hospitalisations related to chronic hepatitis C (CHC) infections in France in 2012.
All hospital stays with CHC (ICD-10 code B18.2) coded as the principal, related or significantly associated diagnosis were extracted from the French National Hospital database 2012 (PMSI). Hospitalisations not directly related to CHC were excluded. Patients were assigned to a liver disease stage, namely non-cirrhotic liver disease, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma or post-liver transplantation. Costing was performed using French national tariffs and expressed in 2013 Euros. We documented 22,056 hospital stays involving 12,040 patients who were considered to be directly related to CHC. Of these stays, 11,779 (53.4%) were documented in patients with severe complications (decompensated cirrhosis, hepatocellular carcinoma or liver transplantation).
The mean number and duration of hospital stays increased with disease severity. Overall, 1181 patients (9.8%) died during hospitalisation. The total cost of hospital stays for CHC was estimated to be € 61 million, of which 26.4% were attributable to hepatocellular carcinoma, 32.5% to post-liver transplantation and 21.0% to decompensated cirrhosis. Compared with a previous analysis in 2009, the number of patients hospitalised fell by 22%, although the patients hospitalised were overall more severely ill. The total cost of hospitalisation decreased by 8%, with a notably marked reduction in the number of biopsies performed (32%). This study illustrates the persistently high burden of CHC infections in France.
本回顾性医院数据库分析旨在确定 2012 年法国慢性丙型肝炎（CHC）感染相关住院治疗的负担和费用。
从法国国家医院数据库 2012 年（PMSI）中提取所有 CHC（ICD-10 编码 B18.2）作为主要、相关或显著相关诊断的住院治疗。排除与 CHC 不直接相关的住院治疗。将患者分配到肝病阶段，即非肝硬化性肝病、代偿性肝硬化、失代偿性肝硬化、肝细胞癌或肝移植后。使用法国国家关税进行成本核算，并以 2013 年欧元表示。我们记录了 22056 例与 12040 例患者直接相关的 CHC 住院治疗。在这些住院治疗中，有 11779 例（53.4%）是严重并发症（失代偿性肝硬化、肝细胞癌或肝移植）患者。
住院次数和持续时间随着疾病严重程度的增加而增加。总体而言，1181 名患者（9.8%）在住院期间死亡。CHC 住院治疗的总费用估计为 6100 万欧元，其中 26.4%归因于肝细胞癌，32.5%归因于肝移植后，21.0%归因于失代偿性肝硬化。与 2009 年的先前分析相比，住院患者人数下降了 22%，尽管住院患者总体上病情更严重。住院治疗总费用下降了 8%，活检数量显著减少（32%）。本研究说明了法国 CHC 感染的负担仍然很高。
