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Título: | Disease severity predicts higher healthcare costs among hospitalized nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) patients in Spain |
Autor: | Romero-Gómez, Manuel CSIC ORCID CVN; Kachru, Nandita; Zamorano Ascanio, Meritxell; Darba, Josep; Shreay, Sanatan | Palabras clave: | Advanced liver diseases Comorbidities Costs Length of stay NAFLD NASH |
Fecha de publicación: | 11-dic-2020 | Editor: | Lippincott Williams & Wilkins | Citación: | Medicine 99(50): e23506 (2020) | Resumen: | The rising prevalence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) presents many public health challenges, including a substantial impact on healthcare resource utilization and costs. There are important regional differences in the burden of NAFLD/NASH, and Spain-specific data are lacking. This retrospective, observational study examined the impact of liver disease severity, comorbidities, and demographics on healthcare resource utilization and costs in Spain. NAFLD/NASH patients in the Spanish National Health System's Hospital Discharge Records Database (1/1/2006 to 4/30/2017) were categorized into disease severity cohorts as NAFLD/NASH overall, NAFLD/NASH non-progressors, compensated cirrhosis (CC), decompensated cirrhosis (DCC), liver transplant (LT), or hepatocellular carcinoma (HCC). Patients were followed from index date until the earliest of 6 months, disease progression, end of coverage, death, or end of study. Within each cohort, pre- and post-index healthcare resource utilization and costs per patient per month (PPPM) were calculated. A total of 8,205 patients (mean age 58.4; 54% male) were identified; 5,984 (72.9%) were non-progressors, 139 (1.7%) progressed to CC, 2,028 (24.7%) to DCC, 115 (1.4%) to LT, and 61 (0.7%) to HCC. Pre-index comorbidity burden was high across disease cohorts, and the frequency of comorbidities increased with disease severity. From pre- to post-index, average length of stay (LOS) increased significantly (23%–41%) as did all-cause PPPM costs (44%–46%), with significantly longer LOS and costs in patients with increasing disease severity. Progression of NAFLD/NASH was associated with significantly higher costs and longer LOS. A coordinated approach is needed to manage resources and costs in Spain. | Versión del editor: | http://doi.org/10.1097/MD.0000000000023506 | URI: | http://hdl.handle.net/10261/236799 | DOI: | 10.1097/MD.0000000000023506 | Identificadores: | doi: 10.1097/MD.0000000000023506 e-issn: 1536-5964 issn: 0025-7974 |
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