The SCottish alcoholic liver disease evaluation: a population-level matched cohort study of hospital-based costs, 1991-2011

Bouttell, J. , Lewsey, J. , Geue, C. , Antony, G., Briggs, A. , McCartney, G., Hutchinson, S., Graham, L. and Heydtmann, M. (2016) The SCottish alcoholic liver disease evaluation: a population-level matched cohort study of hospital-based costs, 1991-2011. PLoS ONE, 11(10), e0162980. (doi: 10.1371/journal.pone.0162980) (PMID:27783619) (PMCID:PMC5082635)

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Studies assessing the costs of alcoholic liver disease are lacking. We aimed to calculate the costs of hospitalisations before and after diagnosis compared to population controls matched by age, sex and socio-economic deprivation. We aimed to use population level data to identify a cohort of individuals hospitalised for the first time with alcoholic liver disease in Scotland between 1991 and 2011.Incident cases were classified by disease severity, sex, age group, socio-economic deprivation and year of index admission. 5 matched controls for every incident case were identified from the Scottish population level primary care database. Hospital costs were calculated for both cases and controls using length of stay from morbidity records and hospital-specific daily rates by specialty. Remaining lifetime costs were estimated using parametric survival models and predicted annual costs. 35,208 incident alcoholic liver disease hospitalisations were identified. Mean annual hospital costs for cases were 2.3 times that of controls pre diagnosis (£804 higher) and 10.2 times (£12,774 higher) post diagnosis. Mean incident admission cost was £6,663. Remaining lifetime cost for a male, 50–59 years old, living in the most deprived area diagnosed with acoholic liver disease was estimated to be £65,999 higher than the matched controls (£12,474 for 7.43 years remaining life compared to £1,224 for 21.8 years). In Scotland, alcoholic liver disease diagnosis is associated with significant increases in admissions to hospital both before and after diagnosis. Our results provide robust population level estimates of costs of alcoholic liver disease for the purposes of health-care delivery, planning and future cost-effectiveness analyses.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Bouttell, Dr Janet and Heydtmann, Dr Mathis and Graham, Dr Lesley and Lewsey, Professor Jim and Briggs, Professor Andrew and Geue, Dr Claudia and Antony, Dr Grace
Authors: Bouttell, J., Lewsey, J., Geue, C., Antony, G., Briggs, A., McCartney, G., Hutchinson, S., Graham, L., and Heydtmann, M.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
Journal Name:PLoS ONE
Publisher:Public Library of Science
ISSN (Online):1932-6203
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in PLoS ONE 11(10): e0162980
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
596991Scottish Alcoholic Liver Disease Evaluation of epidemiology and costs of first and subsequent hospital admissions (SCALE)James LewseyScottish Executive Health Department (SEHHD-CSO)CZH/4/837IHW - HEALTH ECON & TECH ASSESSMENT