Hospitalization for hepatitis C increased significantly between 2005 and 2014, especially among baby boomers, men, African-American and Hispanic patients, and patients with mental health and substance abuse disorders, according to data from a Healthcare Cost and Utilization Project statistical brief.
“Baby boomers are aging and I think that's where we're seeing the greatest increase in hospitalizations,” Quyen Ngo-Metzger, MD, MPH, from the Harvard School of Medicine, Massachusetts, and lead study author, told Healio Gastroenterology and Hepatology. “What’s really interesting, though, is that if you look at both the young age groups, say 18 to 50 years, and the older age groups, both of those age groups showed large numbers of comorbid diseases.”
Between 2005 and 2014, hospitalization for HCV was significantly more common than stays involving HCV plus hepatitis B, HIV or acute liver disease. Specifically, the researchers observed 342,400 HCV-only stays vs. 114,700 comorbid stays in 2005 and 509,700 HCV-only stays vs. 127,200 comorbid stays in 2014, for an increase of 48.9% vs. 10.9%.
The rate for hospitalization among patients aged 52 years to 72 years, or the baby boomer generation, increased by 67.3% between 2005 and 2014, followed by 12.2% among patients aged 73 years or older. In contrast, the researchers observed a 14.9% decrease among patients aged 18 years to 51 years.
“As the baby boomers are aging, hepatitis C is truly affecting them,” Ngo-Metzger said. “They had hepatitis C before, but now they're in this middle age group where you're seeing them hospitalized.”
By demographic, other significant increases in hospitalization for HCV compared with hospitalization for other indications included men (61.5% vs. 47.9%), African-American patients (26.1% vs. 14%), Hispanic patients (10.1% vs. 7.9%), patients on Medicaid (38.1% vs. 17.4%), patients residing in low-income areas (40% vs. 28.8%) and patients residing in large central metropolitan areas (37.3% vs. 29.5%).
Mental health disorders (71.6% vs. 44.3%) and (34.2% vs. 5.7%) were more common codiagnoses among hospitalized patients with HCV than those without HCV. Among patients aged 18 years to 51 years, mental health disorder codiagnosis was present in 78.4% of stays and substance use disorders in 53.5% of stays.
Similarly, alcohol-related diagnosis unrelated to acute liver disease occurred more often in hospitalizations for HCV than for other indications (26% vs. 5.7%), especially in the younger 18 years to 51 years age group and the baby boomer group.
The researchers observed that the most significant overlapping demographics were men, African-Americans and those on Medicaid within the baby boomer generation.
“What I think is really important for hepatologists and others is that when these patients are coming into the hospital, it's not just about hepatitis C, that there are certainly these other mental health issues that need to be addressed as well,” Ngo-Metzger concluded. – by Talitha Bennett
Reference: Statistical Brief #232. Healthcare Cost and Utilization Project (HCUP). November 2017. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb232-Hepatitis-C-Hospital-Stays-Trends.jsp. Accessed: Feb. 7, 2018.
Disclosure: Ngo-Metzger reports no relevant financial disclosures.