BACKGROUND: Nearly 1% of Canadians are infected with the hepatitis C virus (HCV). Simulation analyses have suggested that HCV will place an increasing burden on the health care system as the infected population ages, but supportive clinical data are limited. OBJECTIVES: To study temporal trends in HCV-related hospitalizations and predictors of increased health care utilization from a Canadian population-based perspective. METHODS: An administrative hospitalization database from the Calgary Health Region was used to identify patients who were admitted for HCV between 1994 and 2004. The primary outcomes were liver-related HCV hospitalizations, length of stay, hospital costs and in-hospital mortality. Average annual growth rates in outcomes were calculated and subgroup analyses were conducted according to age, sex and HIV/HCV coinfection status. RESULTS: Between 1994 and 2004, there were 4002 HCV-related hospitalizations; 22% were liver-related. Liver-related hospitalizations, lengths of stay and in-hospital mortality increased approximately fourfold or an average of 15% to 18% annually (P<0.0005). Patients aged 40 to 59 years and HIV/HCV coinfected patients experienced the largest average annual growth rates (19% to 27% and 30% to 40%, respectively; P<0.0005), reflecting the accelerated natural history of HCV in these subgroups. Hospital costs for liver-related HCV hospitalizations increased by an average of 41% annually (P=0.001) between 2000 and 2004. The average annual increase in liver-related hospitalizations remained significant in a sensitivity analysis, even when 75% of HCV cases were under-reported in 1994. CONCLUSIONS: The present studies' findings confirm the growing burden of HCV on the Canadian health care system. Strategies to prevent HCV infection and maximize the dissemination and most effective use of potentially curative antiviral therapies are necessary to reduce these trends.
BACKGROUND: Nearly 1% of Canadians are infected with the hepatitis C virus (HCV). Simulation analyses have suggested that HCV will place an increasing burden on the health care system as the infected population ages, but supportive clinical data are limited. OBJECTIVES: To study temporal trends in HCV-related hospitalizations and predictors of increased health care utilization from a Canadian population-based perspective. METHODS: An administrative hospitalization database from the Calgary Health Region was used to identify patients who were admitted for HCV between 1994 and 2004. The primary outcomes were liver-related HCV hospitalizations, length of stay, hospital costs and in-hospital mortality. Average annual growth rates in outcomes were calculated and subgroup analyses were conducted according to age, sex and HIV/HCV coinfection status. RESULTS: Between 1994 and 2004, there were 4002 HCV-related hospitalizations; 22% were liver-related. Liver-related hospitalizations, lengths of stay and in-hospital mortality increased approximately fourfold or an average of 15% to 18% annually (P<0.0005). Patients aged 40 to 59 years and HIV/HCV coinfectedpatients experienced the largest average annual growth rates (19% to 27% and 30% to 40%, respectively; P<0.0005), reflecting the accelerated natural history of HCV in these subgroups. Hospital costs for liver-related HCV hospitalizations increased by an average of 41% annually (P=0.001) between 2000 and 2004. The average annual increase in liver-related hospitalizations remained significant in a sensitivity analysis, even when 75% of HCV cases were under-reported in 1994. CONCLUSIONS: The present studies' findings confirm the growing burden of HCV on the Canadian health care system. Strategies to prevent HCV infection and maximize the dissemination and most effective use of potentially curative antiviral therapies are necessary to reduce these trends.
Authors: Y Benhamou; M Bochet; V Di Martino; F Charlotte; F Azria; A Coutellier; M Vidaud; F Bricaire; P Opolon; C Katlama; T Poynard Journal: Hepatology Date: 1999-10 Impact factor: 17.425
Authors: H Yoshida; Y Shiratori; M Moriyama; Y Arakawa; T Ide; M Sata; O Inoue; M Yano; M Tanaka; S Fujiyama; S Nishiguchi; T Kuroki; F Imazeki; O Yokosuka; S Kinoyama; G Yamada; M Omata Journal: Ann Intern Med Date: 1999-08-03 Impact factor: 25.391
Authors: María Buti; Ramón San Miguel; Max Brosa; Juan M Cabasés; Montserrat Medina; Miguel Angel Casado; Leslie Fosbrook; Rafael Esteban Journal: J Hepatol Date: 2005-05 Impact factor: 25.083
Authors: Gregory L Armstrong; Annemarie Wasley; Edgar P Simard; Geraldine M McQuillan; Wendi L Kuhnert; Miriam J Alter Journal: Ann Intern Med Date: 2006-05-16 Impact factor: 25.391
Authors: G Kuo; Q L Choo; H J Alter; G L Gitnick; A G Redeker; R H Purcell; T Miyamura; J L Dienstag; M J Alter; C E Stevens Journal: Science Date: 1989-04-21 Impact factor: 47.728
Authors: Robert P Myers; Pam Crotty; Susanna Town; Janine English; Kevin Fonseca; Raymond Tellier; Mark G Swain; S Elizabeth McGregor; Steven J Heitman; Robert J Hilsden Journal: CMAJ Open Date: 2015-01-13