Abstract：
UNASSIGNED: To investigate hepatitis A-related healthcare resource use and costs in the US.
UNASSIGNED: The Merative Marketscan Commercial Claims and Encounters database was retrospectively analyzed for hepatitis A-related inpatient, outpatient, and emergency department (ED) claims from January 1, 2012 to December 31, 2018. We calculated the hepatitis A incidence proportion per 100,000 enrollees, healthcare resource utilization, and costs (in 2020 USD). Results were stratified by age, gender, and select comorbidities.
UNASSIGNED: The overall hepatitis A incidence proportion was 6.1 per 100,000 enrollees. Among individuals with ≥1 hepatitis A-related claim, the majority (92.6%) had ≥1 outpatient visit related to hepatitis A; 9.1% were hospitalized and 4.2% had ≥1 ED visit. The mean (standard deviation [SD]) length of hospital stay was 5.2 (8.1) days; the mean (SD) number of outpatient and ED visits were 1.3 (1.3) and 1.1 (0.6), respectively. The incidence proportion per 100,000 was higher among adults than children (7.5 vs. 1.5), individuals with HIV than those without (126.7 vs. 5.9), and individuals with chronic liver disease than those without (143.6 vs. 3.8). The total mean (SD)/median (interquartile range, IQR) per-patient cost for hepatitis A-related care was $2,520 ($10,899)/$156 ($74-$529) and the mean cost of hospitalization was 18.7 times higher than that of outpatient care ($17,373 vs. $928).
UNASSIGNED: The study data included only a commercially insured population and may not be representative of all individuals.
UNASSIGNED: In conclusion, hepatitis A is associated with a substantial economic burden among privately insured individuals in the US.
Hepatitis A is an acute liver infection caused by the hepatitis A virus. In the US, safe and effective vaccines for hepatitis A have been available since 1996. Vaccination recommendations include children (all children aged 12–23 months and previously unvaccinated children aged 2–18 years old) and adults at risk of infection or severe disease (e.g. international travelers, men who have sex with men, persons experiencing homelessness, persons with chronic liver disease or persons with HIV infection). Since 2016, the US has experienced person-to-person outbreaks of hepatitis A, primarily affecting unvaccinated individuals who use drugs or are experiencing homelessness. To better understand the impact of hepatitis A in the US, we assessed healthcare resource use and costs in 15,435 patients with hepatitis A from 2012 to 2018 in the Merative Marketscan Commercial Claims and Encounters database. We found that slightly more than 6 per 100,000 enrollees had hepatitis A from 2012 to 2018 and the number of people treated for hepatitis A per 100,000 was highest for people living with HIV or with chronic liver disease. The majority (92.6%) of people reported at least an outpatient visit, 9.1% were hospitalized, and 4.2% had an emergency department visit. The average cost for hepatitis A-related care was $2,520 per patient and was 18.7 times higher for hospitalized patients ($17,373) than for patients treated in outpatient care ($928). Our results are limited by the generalizability of the dataset, which is a convenience sample of private insurance claims, and are therefore unlikely to capture groups at high-risk for hepatitis A, such as individuals experiencing homelessness. In conclusion, hepatitis A leads to considerable healthcare costs for privately insured individuals in the US.
UNASSIGNED: The Merative Marketscan Commercial Claims and Encounters database was retrospectively analyzed for hepatitis A-related inpatient, outpatient, and emergency department (ED) claims from January 1, 2012 to December 31, 2018. We calculated the hepatitis A incidence proportion per 100,000 enrollees, healthcare resource utilization, and costs (in 2020 USD). Results were stratified by age, gender, and select comorbidities.
UNASSIGNED: The overall hepatitis A incidence proportion was 6.1 per 100,000 enrollees. Among individuals with ≥1 hepatitis A-related claim, the majority (92.6%) had ≥1 outpatient visit related to hepatitis A; 9.1% were hospitalized and 4.2% had ≥1 ED visit. The mean (standard deviation [SD]) length of hospital stay was 5.2 (8.1) days; the mean (SD) number of outpatient and ED visits were 1.3 (1.3) and 1.1 (0.6), respectively. The incidence proportion per 100,000 was higher among adults than children (7.5 vs. 1.5), individuals with HIV than those without (126.7 vs. 5.9), and individuals with chronic liver disease than those without (143.6 vs. 3.8). The total mean (SD)/median (interquartile range, IQR) per-patient cost for hepatitis A-related care was $2,520 ($10,899)/$156 ($74-$529) and the mean cost of hospitalization was 18.7 times higher than that of outpatient care ($17,373 vs. $928).
UNASSIGNED: The study data included only a commercially insured population and may not be representative of all individuals.
UNASSIGNED: In conclusion, hepatitis A is associated with a substantial economic burden among privately insured individuals in the US.
Hepatitis A is an acute liver infection caused by the hepatitis A virus. In the US, safe and effective vaccines for hepatitis A have been available since 1996. Vaccination recommendations include children (all children aged 12–23 months and previously unvaccinated children aged 2–18 years old) and adults at risk of infection or severe disease (e.g. international travelers, men who have sex with men, persons experiencing homelessness, persons with chronic liver disease or persons with HIV infection). Since 2016, the US has experienced person-to-person outbreaks of hepatitis A, primarily affecting unvaccinated individuals who use drugs or are experiencing homelessness. To better understand the impact of hepatitis A in the US, we assessed healthcare resource use and costs in 15,435 patients with hepatitis A from 2012 to 2018 in the Merative Marketscan Commercial Claims and Encounters database. We found that slightly more than 6 per 100,000 enrollees had hepatitis A from 2012 to 2018 and the number of people treated for hepatitis A per 100,000 was highest for people living with HIV or with chronic liver disease. The majority (92.6%) of people reported at least an outpatient visit, 9.1% were hospitalized, and 4.2% had an emergency department visit. The average cost for hepatitis A-related care was $2,520 per patient and was 18.7 times higher for hospitalized patients ($17,373) than for patients treated in outpatient care ($928). Our results are limited by the generalizability of the dataset, which is a convenience sample of private insurance claims, and are therefore unlikely to capture groups at high-risk for hepatitis A, such as individuals experiencing homelessness. In conclusion, hepatitis A leads to considerable healthcare costs for privately insured individuals in the US.
摘要：
瞄准.调查美国与甲型肝炎相关的医疗保健资源使用和成本。方法。对与甲型肝炎相关的住院患者进行了回顾性分析，门诊病人,和急诊科（ED）从2012年1月1日至2018年12月31日的索赔。我们计算了每100,000名参与者的甲型肝炎发病率比例，医疗保健资源利用，和成本（以2020美元计算）。结果按年龄分层，性别,并选择合并症。结果。总体甲型肝炎发病率为每100,000名参与者6.1。在甲型肝炎相关索赔≥1的个体中，大多数（92.6％）与甲型肝炎相关的门诊就诊≥1次；9.1％住院，4.2%的患者有≥1次ED访视。平均（标准差[SD]）住院时间为5.2（8.1）天；平均（SD）门诊和ED就诊次数为1.3（1.3）和1.1（0.6），分别。成人中每10万人的发病率高于儿童(7.5vs.1.5),艾滋病毒感染者比没有艾滋病毒的人(126.7vs.5.9),和患有慢性肝病的人比没有慢性肝病的人(143.6vs.3.8).甲型肝炎相关护理的每位患者费用的总平均（SD）/中位数（IQR）为$2,520（$10,899）/$156（$74-$529），平均住院费用是门诊护理的18.7倍（$17,373vs.928美元)。局限性。研究数据仅包括商业保险人群，可能不代表所有个人。Conclusions.总之,在美国，甲型肝炎与私人保险个人的巨大经济负担有关。
甲型肝炎是由甲型肝炎病毒引起的急性肝脏感染。在美国,自1996年以来，人们已经提供了安全有效的甲型肝炎疫苗。疫苗接种建议包括儿童（所有12至23个月的儿童和以前未接种疫苗的2至18岁儿童）和有感染或严重疾病风险的成年人（例如，国际旅行者,和男人发生性关系的男人,经历无家可归的人，患有慢性肝病或艾滋病毒的人)。自2016年以来，美国经历了人对人的甲型肝炎爆发，主要影响使用药物或无家可归的未接种疫苗的人。为了更好地了解甲型肝炎在美国的影响，我们评估了2012年至2018年甲型肝炎患者的医疗资源使用和成本,包括MerativeMarketscan商业索赔和遭遇数据库中的15,435名甲型肝炎相关保险索赔的个人.我们发现，从2012年到2018年，每100,000名参与者中略多于6名患有甲型肝炎，每100,000名接受甲型肝炎治疗的人数对于艾滋病毒感染者或慢性肝病患者来说是最高的。大多数人(92.6%)报告至少有一次门诊就诊，9.1%住院，4.2%有急诊就诊。甲型肝炎相关护理的平均费用为每位患者2,520美元，住院患者（17,373美元）比门诊治疗患者（928美元）高18.7倍。我们的结果受到数据集的泛化性的限制，这是私人保险索赔的便利样本，不太可能捕获甲型肝炎高危人群，比如经历无家可归的人。总之,甲型肝炎导致美国私人保险个人的医疗费用可观。
甲型肝炎是由甲型肝炎病毒引起的急性肝脏感染。在美国,自1996年以来，人们已经提供了安全有效的甲型肝炎疫苗。疫苗接种建议包括儿童（所有12至23个月的儿童和以前未接种疫苗的2至18岁儿童）和有感染或严重疾病风险的成年人（例如，国际旅行者,和男人发生性关系的男人,经历无家可归的人，患有慢性肝病或艾滋病毒的人)。自2016年以来，美国经历了人对人的甲型肝炎爆发，主要影响使用药物或无家可归的未接种疫苗的人。为了更好地了解甲型肝炎在美国的影响，我们评估了2012年至2018年甲型肝炎患者的医疗资源使用和成本,包括MerativeMarketscan商业索赔和遭遇数据库中的15,435名甲型肝炎相关保险索赔的个人.我们发现，从2012年到2018年，每100,000名参与者中略多于6名患有甲型肝炎，每100,000名接受甲型肝炎治疗的人数对于艾滋病毒感染者或慢性肝病患者来说是最高的。大多数人(92.6%)报告至少有一次门诊就诊，9.1%住院，4.2%有急诊就诊。甲型肝炎相关护理的平均费用为每位患者2,520美元，住院患者（17,373美元）比门诊治疗患者（928美元）高18.7倍。我们的结果受到数据集的泛化性的限制，这是私人保险索赔的便利样本，不太可能捕获甲型肝炎高危人群，比如经历无家可归的人。总之,甲型肝炎导致美国私人保险个人的医疗费用可观。
