The cost of dying of end-stage liver disease.
Arch Intern Med
; 157(13): 1429-32, 1997 Jul 14.
Article
em En
| MEDLINE
| ID: mdl-9224220
ABSTRACT
BACKGROUND:
The high cost of liver transplantation is well known. The cost of dying of complications of end-stage liver disease (ESLD) without transplant, however, has not been well documented.METHODS:
For a 5-year period (1991-1995), in 153 patients, mean inpatient hospital charges and length of stay were analyzed in 6 groups of patients (1) patients admitted with the primary diagnosis of esophageal varices, (1a) the subset of group 1 patients who died on this admission, (2) patients admitted to the liver team who died of complications from ESLD, (3) patients who underwent transjugular intrahepatic portosystemic shunts, (4) patients who underwent surgical shunt for bleeding varices, and (5) patients who underwent liver transplantation.RESULTS:
One hundred twenty-nine patients with esophageal varices were hospitalized 13.7 days with a mean charge of $30,980 for each of 202 admissions. Of these, 38 died after 24 days with a mean charge of $67,091. Seven patients admitted to the liver team died of complications of ESLD at $110,576 per admission. Transjugular intrahepatic portosystemic shunt was performed in 17 patients with a mean charge of $43,209. Six patients underwent surgical shunt for $53,994. Mean charge for 7 liver transplantations was $222,968. During the study period, 36.7% of all charges were for patients who died.CONCLUSIONS:
It is difficult to estimate the total cost of ESLD; however, in evaluating inpatient costs, we see that it is expensive and significant amounts are spent on patients who die. Further study is necessary to determine which factors can optimize the cost of ESLD.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Derivação Portossistêmica Cirúrgica
/
Transplante de Fígado
/
Falência Hepática
Tipo de estudo:
Etiology_studies
/
Health_economic_evaluation
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Arch Intern Med
Ano de publicação:
1997
Tipo de documento:
Article
País de afiliação:
Estados Unidos