Mitra D, Candrilli SD. Inpatient costs and outcomes associated with hepatitis c, human immunodeficiency virus, and co-infection with both in the United States. Poster presented at the 2008 ISPOR 11th Annual European Congress; November 8, 2008. [abstract] Value Health. 2008 Nov; 11(6):A440-1.

OBJECTIVES: We generate national estimates of inpatient costs, length of stay (LOS), and probability of death among patients infected with Hepatitis C Virus (HCV), human immunodeficiency virus (HIV), and those co-infected with both.

METHODS: Discharge data from the 2005 HCUP Nationwide Inpatient Sample, the largest all-payer inpatient care database in the United States (US) were analyzed. Hospitalizations were categorized into mutually exclusive groups based on ICD-9-CM diagnosis codes: HCV only, HIV only, HCV and HIV, and no HCV or HIV. Weighted estimates of LOS, costs, and probability of death were calculated for each stay.

RESULTS: There were 390,975 hospitalizations for HCV, 136,596 for HIV, and 26,000 for HCV and HIV co-infections. The average LOS for HCV-related hospitalizations was 6.03 days. LOS for HIV-related hospitalizations was higher at 7.87 days (P < 0.0001), similar to the LOS for hospitalizations pertaining to HCV and HIV co-infection (7.88 days). In comparison, hospitalizations not related to HCV or HIV had an average LOS of only 4.62 days. The total cost per hospitalization was also lowest for HCV at $11,797 and was significantly higher for HIV ($14,595, P < 0.0001). The total cost per hospitalization for HIV and HCV co-infections was $14,686. The total cost of non-HCV or HIV hospitalizations was nearly half ($8,859). The probability of death associated with HCV, HIV, and co-infected HCV and HIV was 3.5%, 5.1% and 5.6% respectively while the probability of death associated with non- HIV or HIV-related hospitalizations was only 2.1%.

CONCLUSIONS: This is one of few studies to quantify differences in inpatient costs and outcomes associated with HCV, HIV, and HCV and HIV co-infection in a multi-payer US population. Hospitalizations related to HCV and HIV co-infections were longer and more expensive compared to those related to HCV only. Policy and other decision makers should be aware of this burden as strategies to allocate resources are developed.

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