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- Title
Race/Ethnicity and Insurance-Specific Disparities in In-Hospital Mortality Among Adults with Primary Biliary Cholangitis: Analysis of 2007-2014 National Inpatient Sample.
- Authors
Galoosian, Artin; Hanlon, Courtney; Tana, Michele; Cheung, Ramsey; Wong, Robert J.
- Abstract
<bold>Background: </bold>Primary biliary cholangitis (PBC) is a progressive autoimmune liver disease that can result in cirrhosis and end-stage liver disease.<bold>Aims: </bold>We aim to evaluate hospitalization burden and in-hospital mortality among PBC patients in the USA.<bold>Methods: </bold>Using data from the Nationwide Inpatient Sample from 2007 to 2014, hospitalizations among US adults with PBC were stratified by sex, age, and race/ethnicity. Overall in-hospital mortality was stratified by these variables and adjusted multivariate regression models evaluated for predictors of in-hospital mortality.<bold>Results: </bold>From 2007 to 2014, there were 18,279 hospitalizations among adults with PBC (15.0% male, mean age 63.8 years, 41.3% cirrhosis). Among non-Hispanic whites, the proportion of total PBC hospitalizations increased from 57.8% in 2007 to 71.2% in 2014, compared to 4.1-6.3% for African-Americans, 8.6-10.9% for Hispanics, and 1.7-2.8% for Asians (p < 0.001 for all). While overall in-hospital mortality was low (4.2%), increasing age was associated with higher odds of in-hospital mortality (OR: 1.02, 95% CI 1.01-1.03, p < 0.001). Compared to non-Hispanic white PBC patients, higher in-hospital mortality was observed in African-American PBC patients (OR: 1.40, 95% CI 1.16-2.03, p < 0.05). Compared to patients with private/commercial insurance, significantly higher odds of in-hospital mortality were observed in patients with Medicaid insurance (OR 1.42, 95% CI 1.00-1.99, p < 0.05).<bold>Conclusion: </bold>In summary, among adults with PBC hospitalized in the USA from 2007 to 2014, the overall number of hospitalizations is increasing. Significant disparities in in-hospital mortality were observed; African-Americans with PBC and Medicaid patients with PBC have disproportionately higher odds of in-hospital mortality.
- Subjects
UNITED States; HOSPITAL mortality; CHOLANGITIS; ETHNICITY; BUSINESS insurance; CIRRHOSIS of the liver; STATISTICS on Hispanic Americans; MEDICAID statistics; HEALTH insurance statistics; RESEARCH; HEALTH services accessibility; AGE distribution; GASTROINTESTINAL hemorrhage; MULTIVARIATE analysis; BLACK people; RESEARCH methodology; HEALTH status indicators; ESOPHAGEAL varices; EVALUATION research; MEDICAL cooperation; SEVERITY of illness index; COMPARATIVE studies; HOSPITAL care; ETHNIC groups; WHITE people; HOSPITAL charges; PORTAL hypertension
- Publication
Digestive Diseases & Sciences, 2020, Vol 65, Issue 2, p406
- ISSN
0163-2116
- Publication type
journal article
- DOI
10.1007/s10620-019-05809-x