title: Chronic hepatitis C: Burden of disease and cost associated with hospitalisations in France in 2012 (The HEPC-LONE study).
abstract: OBJECTIVE
  This retrospective hospital database analysis aimed to determine the burden and cost of hospitalisations related to chronic hepatitis C (CHC) infections in France in 2012.
  
  
  METHODS
  All hospital stays with CHC (ICD-10 code B18.2) coded as the principal, related or significantly associated diagnosis were extracted from the French National Hospital database 2012 (PMSI). Hospitalisations not directly related to CHC were excluded. Patients were assigned to a liver disease stage, namely non-cirrhotic liver disease, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma or post-liver transplantation. Costing was performed using French national tariffs and expressed in 2013 Euros. We documented 22,056 hospital stays involving 12,040 patients who were considered to be directly related to CHC. Of these stays, 11,779 (53.4%) were documented in patients with severe complications (decompensated cirrhosis, hepatocellular carcinoma or liver transplantation).
  
  
  CONCLUSIONS
  The mean number and duration of hospital stays increased with disease severity. Overall, 1181 patients (9.8%) died during hospitalisation. The total cost of hospital stays for CHC was estimated to be € 61 million, of which 26.4% were attributable to hepatocellular carcinoma, 32.5% to post-liver transplantation and 21.0% to decompensated cirrhosis. Compared with a previous analysis in 2009, the number of patients hospitalised fell by 22%, although the patients hospitalised were overall more severely ill. The total cost of hospitalisation decreased by 8%, with a notably marked reduction in the number of biopsies performed (32%). This study illustrates the persistently high burden of CHC infections in France.
authors.affiliation: Department of Digestive Medicine, CHU Estaing, Clermont-Ferrand, France; Unité mixte de recherche Université d'Auvergne CNRS 6284, France.
authors.forename: Armand
authors.initials: A
authors.lastname: Abergel
authors.affiliation: Department of Geriatric Medicine, Centre Hospitalier du Pays d'Aix, Aix-en-Provence, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Rotily
authors.affiliation: Health Economics and Outcomes Research, Laboratoire Bristol-Myers Squibb, 3, rue Joseph-Monier, 92500 Rueil-Malmaison, France. Electronic address: sebastien.branchoux@bms.com.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Branchoux
authors.affiliation: Medical Affairs, Laboratoire Bristol-Myers Squibb, 3, rue Joseph-Monier, 92500 Rueil-Malmaison, France.
authors.forename: Raoudha
authors.initials: R
authors.lastname: Akremi
authors.affiliation: HEVA, Lyon, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: de Léotoing
authors.affiliation: HEVA, Lyon, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Vainchtock
authors.affiliation: Health Economics and Outcomes Research, Laboratoire Bristol-Myers Squibb, 3, rue Joseph-Monier, 92500 Rueil-Malmaison, France.
authors.forename: Anne-Françoise
authors.initials: AF
authors.lastname: Gaudin
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000191:economics / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D019698:Hepatitis C, Chronic / Q000191:economics* / Q000453:epidemiology*; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008103:Liver Cirrhosis / Q000191:economics / Q000453:epidemiology; D008113:Liver Neoplasms / Q000191:economics / Q000453:epidemiology; D016031:Liver Transplantation / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index