First-Ever Study Examines Factors That Drive Higher Hospital Costs of Patients With Alcoholic Liver Disease

Hospital costs for patients with alcoholic liver disease were on average $3,200 higher than for patients admitted for alcohol-related conditions not involving the liver, an AHRQ study found. The study—the first to measure how inpatient costs were impacted by common alcoholic liver disease complications and comorbidities—found that alcoholic liver disease hospital stays averaged $13,543 compared with $10,355 for other alcohol-related disorders. Protein-calorie malnutrition accounted for 12 percent of the higher costs of stays for alcoholic liver disease, according to the analysis. Researchers used data from AHRQ’s Healthcare Cost and Utilization Project to examine more than 350,000 hospital stays nationwide. The study, “Identifying Inpatient Costs Attributable to the Clinical Sequelae and Comorbidities of Alcoholic Liver Disease in a National Hospital Database,” was published in the journal Addiction. Access the abstract.

2016 Nov 25. doi: 10.1111/add.13702. [Epub ahead of print]

Identifying in-patient costs attributable to the clinical sequelae and comorbidities of alcoholic liver disease in a national hospital database.

Heslin KC1, Elixhauser A1, Steiner CA1.

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Abstract

BACKGROUND AND AIMS:

The clinical sequelae and comorbidities of alcoholic liver disease (ALD) often require hospitalization. The aims of this study were to (1) compare the average costs of hospitalizations with ALD and the costs of hospitalizations with other alcohol-related diagnoses that do not involve the liver; and (2) estimate the percentage of the difference in costs between the ALD and non-ALD hospitalizations that may be attributed to ascites, protein-calorie malnutrition and other conditions.

DESIGN:

The 2012 National Inpatient Sample is a population-based cross-sectional database representing more than 94% of all discharges from community hospitals in the United States.

SETTING:

Community hospitals in the United States.

PARTICIPANTS:

The sample included 72 531 hospitalizations with ALD and 287 047 hospitalizations with other alcohol-related diagnoses.

MEASUREMENTS:

The dependent variable was total in-patient costs. We estimated the contribution of ascites, protein-calorie malnutrition and other conditions to the difference in costs between patients with ALD and patients with other diagnoses.

FINDINGS:

Average costs for ALD patients were $3188.4 higher than those for patients with other diagnoses ($13 543 versus $10 355; P < 0.001). Among all conditions in the analysis, protein-calorie malnutrition had the largest impact on costs [$6501; 95% confidence interval (CI) = 5956, 7045; P < 0.001] accounting for 12% of the higher costs of ALD stays.

CONCLUSIONS:

Costs of hospital care for patients with alcoholic liver disease are higher than those for patients with other alcohol-related diagnoses. These increased costs are associated with specific clinical sequelae and comorbidities, with protein-calorie malnutrition-a largely preventable condition-making a substantial contribution.

Published 2016. This article is a U.S. Government work and is in the public domain in the USA.