Access to Care Is Limited for Chronic Liver Disease Patients
Patients with chronic liver disease (CLD) face increasing rates of hospitalization, longer hospital stays, and more readmissions compared with patients with other chronic diseases, according to a new study.
However, CLD patients have worse access to post-acute care despite these adverse outcomes, findings from the study also showed.
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The authors of the study arrived at their conclusion after analyzing 2004-2013 data on hospitalizations for CLD (n = 27,783), chronic heart failure (CHF; n = 60,415), and chronic obstructive pulmonary disease (COPD; n = 34,199), obtained from a large health care system in Texas.
Annual hospitalization rates (per 100,000) were calculated, and factors including hospital course, inpatient mortality, ancillary services, and readmissions were compared between groups.
Ultimately, the rate of CLD-related hospitalization increased by 92% from 2004 (1295 per 100,000) to 2013 (2490 per 100,000), while hospitalizations increased by 6.7% for CHF (from 3843 per 100,000 to 4103 per 100,000) and by 48.8% for COPD (from 1775 per 100,000 to 2642 per 100,000) during this time period.
CLD patients had longer hospital lengths of stay (7.3 days) compared with CHF patients (6.2 days) and COPD patients (5.9 days). A significantly smaller proportion of patients with CLD were able to access post-acute care (13.2%) vs CHF patients (23.2%) or COPD patients (27.4%).
The rate of hospital readmission was higher among patients with CLD (25.0%) than patients with CHF (21.9%) or COPD (20.6%)
In addition, a higher proportion of CLD patients died or were placed in hospice (14.2%) compared with CHF patients (11.5%) and COPD patients (9.3%).
With this data in mind, the authors of the study emphasized that “disease management models for chronic liver disease are greatly needed to manage the anticipated increase in hospitalizations for CLD.”
Asrani SK, Kouznetsova M, Ogola G, et al. Increasing healthcare burden of chronic liver disease compared to other chronic diseases, 2004-2013 [Published online May 23, 2018]. Gastroenterology. https://doi.org/10.1053/j.gastro.2018.05.032