Teshale E H, Xing J, Moorman A, Holmberg S D, Spradling P R, Gordon S C, Rupp L B, Lu M, Boscarino J A, Trinacity C M, Schmidt M A, Xu F
Division of Viral Hepatitis, CDC, Atlanta, GA, USA.
Henry Ford Hospital, Detroit, MI, USA.
J Viral Hepat. 2016 Oct;23(10):748-54. doi: 10.1111/jvh.12548. Epub 2016 May 15.
In the United States, hospitalization among patients with chronic hepatitis C virus (HCV) infection is high. The healthcare burden associated with hospitalization is not clearly known. We analysed data from the Chronic Hepatitis Cohort Study, an observational cohort of patients receiving care at four integrated healthcare systems, collected from 2006 to 2013 to determine all-cause hospitalization rates of patients with chronic HCV infection and the other health system patients. To compare the hospitalization rates, we selected two health system patients for each chronic HCV patient using their propensity score (PS). Propensity score matching was conducted by site, gender, race, age and household income to minimize differences attributable to these characteristics. We also compared primary reason for hospitalization between chronic HCV patients and the other health system patients. Overall, 10 131 patients with chronic HCV infection and 20 262 health system patients were selected from the 1 867 802 health system patients and were matched by PS. All-cause hospitalization rates were 27.4 (27.0-27.8) and 7.4 (7.2-7.5) per 100 persons-year (PY) for chronic HCV patients and for the other health system patients, respectively. Compared to health system patients, hospitalization rates were significantly higher by site, gender, age group, race and household income among chronic HCV patients (P < 0.001). Compared to health system patients, chronic HCV patients were more likely to be hospitalized from liver-related conditions (RR = 24.8, P < 0.001). Hence, patients with chronic HCV infection had approximately 3.7-fold higher all-cause hospitalization rate than other health system patients. These findings highlight the incremental costs and healthcare burden of patients with chronic HCV infection associated with hospitalization.
在美国，慢性丙型肝炎病毒（HCV）感染患者的住院率很高。与住院相关的医疗负担尚不清楚。我们分析了慢性丙型肝炎队列研究的数据，该研究是对在四个综合医疗系统接受治疗的患者进行的观察性队列研究，数据收集于2006年至2013年，以确定慢性HCV感染患者和其他医疗系统患者的全因住院率。为了比较住院率，我们使用倾向评分（PS）为每位慢性HCV患者选择两名医疗系统患者。通过地点、性别、种族、年龄和家庭收入进行倾向评分匹配，以尽量减少这些特征造成的差异。我们还比较了慢性HCV患者和其他医疗系统患者的主要住院原因。总体而言，从1867802名医疗系统患者中选出了10131名慢性HCV感染患者和20262名医疗系统患者，并按PS进行了匹配。慢性HCV患者和其他医疗系统患者的全因住院率分别为每100人年（PY）27.4（27.0 - 27.8）和7.4（7.2 - 7.5）。与医疗系统患者相比，慢性HCV患者在地点、性别、年龄组、种族和家庭收入方面的住院率显著更高（P < 0.001）。与医疗系统患者相比，慢性HCV患者因肝脏相关疾病住院的可能性更大（RR = 24.8，P < 0.001）。因此，慢性HCV感染患者的全因住院率比其他医疗系统患者高约3.7倍。这些发现凸显了慢性HCV感染患者与住院相关的额外成本和医疗负担。
