Hospitalizations due to hepatitis C in Los Angeles County, 2007-2009: case characteristics and factors associated with mortality

Abstract

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.