Insurance Status Linked to Post-Discharge Outcome in Patients with Cirrhosis

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Disclosures: The authors do not report any relevant financial disclosures.

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Jasmohan S. Bajaj

Insurance status was independently associated with acute over chronic liver failure in patients with cirrhosis in an analysis of North American data published in Clinical gastroenterology and hepatology.

“The impact of confidence, race and ethnicity on outcome in patients with cirrhosis who are hospitalized is relevant in the overall prognosis” Jasmohan S. Bajaj, MD, from the Division of Gastroenterology, Hepatology and Nutrition at Virginia Commonwealth University, said Healio Gastroenterology.

To explore the impact of insurance status on outcomes 90 days after discharge, the researchers analyzed data from the North American Consortium for the Study of End-Stage Liver Disease database. The study included patients with private insurance (n = 971), Medicare (n = 770) and Medicaid (n = 265), as well as Canadian patients (n = 456) and uninsured patients (n = 178).

Overall, 23% of patients were admitted to the intensive care unit, 12% developed CFL, 7% died, and 5% underwent liver transplantation. Of the 2,288 patients who were discharged from hospital, 12% underwent liver transplantation, 19% died and 42% were readmitted within 90 days.

In their analysis, the researchers determined that lack of confidence was associated with ACLF (P = .02) and inversely associated with liver transplantation in a hospitalized patient (P = .05) and a 90-day liver transplant (P = .02).

Patients without insurance also had the highest percentage of alcohol-related or bleeding admissions and the lowest proportion of ambulatory medication use related to cirrhosis.

“We found in our cohort of 2,640 hospitalized patients with cirrhosis that uninsured patients were more likely to be hospitalized for potentially preventable conditions, to develop acute over chronic liver failure at higher rates and also not not be eligible for a liver transplant during admission or at 90 days. “Bajaj said.” Being insured, regardless of the type of insurance such as Medicaid, Medicare, private or Canadian was associated with better results. Race or ethnicity did not affect these results. Extending insurance coverage for all patients with cirrhosis may improve these outcomes. – by Alex Young

Disclosures: The authors do not report any relevant financial disclosures.

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