Substantial healthcare utilization (HCU) and costs among nonalcoholic steatohepatitis (NASH) patients with comorbid diabetes mellitus (DM): Real-world analysis of 2007-2015 US medicare data.
Gordon S, Li S, Peng Y, Wang X, and Wong R. Substantial healthcare utilization (HCU) and costs among nonalcoholic steatohepatitis (NASH) patients with comorbid diabetes mellitus (DM): Real-world analysis of 2007-2015 US medicare data. Hepatol Int 2019; 13(Suppl 1):S186-S187.
Introduction/Objectives: This study aimed to evaluate the impact of concurrent DM on HCU and costs among NASH patients with CC. Method: NASH/Non-Alcoholic Fatty Liver Disease (NAFLD) patients with CC aged ≥18 years were extracted from 2007 to 2015 US Medicare 20% sample data via ICD codes. Index date was first CC diagnosis. Other liver diseases were excluded. Comorbidities were defined during 6 months pre-index period (pre). HCU and costs were analyzed during 6 months pre- and post-index period (post), and adjusted to per patient (PP) annual values in 2015 USD. Results: 3775 NASH/NAFLD CC patients with mean age 67.0 (± 10.9) years and 63.3% females were included. More than 98% had ≥1 comorbidities: DM (74.8%), hyperlipidemia (91.6%), and hypertension (93.9%). Annual mean visits (inpatient/outpatient/ physician) for CC cohort were 33.9 (pre) vs. 40.7 (post) (p<0.001). Total costs for CC cohort was $19,385 (pre) vs. $33,504 (post) (p<0.001). Comorbidity burden was high in both CC DM patients and CC non-DM patients: hypertension 97.1% (DM) and 84.7% (non-DM); hyperlipidemia 95.3% (DM) and 80.7% (non-DM). For CC DM patients, mean inpatient visits were 0.52 (pre) vs. 0.99 (post) (p<0.001), and for CC non-DM patients, mean inpatient visits were 0.37 (pre) vs. 0.76 (post) (p<0.001). The total costs for CC DM patients were $20,646 (pre) vs. $35,359 (post) (p<0.001), and for CC non-DM patients were $15,633 (pre) vs. $27,953 (post) (p<0.001). Conclusion: Medicare patients with NASH/NAFLD and CC with/ without DM reported a high comorbidity and HCU burden, suggesting early identification and effective treatment is needed. (Figure Presented) .