title: The impact of chronic hepatitis C on resource utilisation and in-patient mortality for Medicare beneficiaries between 2005 and 2010.
abstract: BACKGROUND
  As baby boomers age, chronic hepatitis C (CHC) will become increasingly important in Medicare eligible group.
  
  
  OBJECTIVE
  To evaluate trends in Medicare resource utilisation for CHC.
  
  
  METHODS
  We analysed the Medicare in-patient and out-patient data from 2005 to 2010. For each patient, all claims with CHC as a principal diagnosis were added up and yearly CHC-related spending was calculated.
  
  
  RESULTS
  A total of 48,880 out-patient claims for 21,655 CHC patients and 4884 hospital admission claims for 3092 patients were included. The number of in-patient (1.5-1.6/year) or out-patient (2.2-2.3/year) visits per patient did not change over time, nor did the demographic characteristics of the CHC population. The majority of this population was eligible for Medicare based on disability and the average number of diagnoses per in-patient claim (from 8.11 in 2005 to 8.60 in 2010) and per out-patient claim (from 2.18 in 2005 to 2.71 in 2010) increased (both P < 0.0001). The average total yearly spending per patient increased in the out-patient setting from $488 in 2005 to $584 in 2010 (P = 0.0132) and did not change in the in-patient setting (from $22,245 in 2005 to $23,383 in 2010, P = 0.14). In the multivariate analysis, the number of diagnoses and conditions per claim and the number of in-patient or out-patient procedures per year were the important independent predictors of increased resource utilisation.
  
  
  CONCLUSIONS
  Most Medicare beneficiaries with chronic hepatitis C who sought in-patient or out-patient care in 2005-2010 had received Medicare for disability. Although the total resource utilisation did not change, the proportion of patient's responsibility increased.
authors.affiliation: Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
authors.forename: Z M
authors.initials: ZM
authors.lastname: Younossi
authors.forename: M
authors.initials: M
authors.lastname: Stepanova
authors.forename: A
authors.initials: A
authors.lastname: Mishra
authors.forename: C
authors.initials: C
authors.lastname: Venkatesan
authors.forename: L
authors.initials: L
authors.lastname: Henry
authors.forename: S
authors.initials: S
authors.lastname: Hunt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D006233:Persons with Disabilities; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D019698:Hepatitis C, Chronic / Q000191:economics / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000191:economics / Q000639:trends*; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D014481:United States