Are Inpatient Admission Rates for Hepatitis C Improving? An Analysis of National Trends in the U.S. from 1997 to 2012

Abstract

Introduction: Hepatitis C is one of the most common outpatient diagnoses in primary care and gastroenterology. There is limited data on the rate and costs associated with inpatient admissions for Hepatitis C. The aim of this study was to estimate the incidence and costs of hospital admissions for Hepatitis C in the United States. Methods: We analyzed the National Inpatient Sample Database (NIS) for all subjects in which Hepatitis C (ICD-9 codes: 070.41, 070.44, 070.51, 070.54, 070.70, 070.71) was the principal discharge diagnosis from 1997-2012. The NIS is the largest publicly available all-payer inpatient care database in the United States. It contains data from approximately 8 million hospital stays each year. The statistical significance of the difference in the number of hospital discharges, length of stay and hospital costs over the study period was determined by utilization of the chi-square test for trend. Results: In 1997, there were 5,777 patients with a principal discharge diagnosis of Hepatitis C as compared to 34,360 in 2012 (p < 0.001, Figure 1). The mean length of stay for Hepatitis C decreased by 14% between 1997 and 2012 at 6.3 to 5.4 days (p < 0.001). However, during this period the mean hospital charges increased by 192.1 % from $18,701 in 1997 to $54,629 in 2012 (p < 0.001, Figure 2). The inpatient mortality rate decreased by 6.05% in 1997 to 4.83% in 2012 (p < 0.001).Figure 1Figure 2Conclusion: The number of inpatient discharges for Hepatitis C has significantly increased between 1997 and 2012 with much of the increment coming in the last 5 years. The cost associated with these admissions has also increased significantly. The length of stay, however, decreased slightly. The in-patient mortality rate also decreased significantly over past 16 years. Inpatient costs associated with Hepatitis C contribute significantly to the total healthcare bill. Further research on the cost effectiveness of diagnostic procedures and therapies in Hepatitis C is required.