National report on healthcare utilization and mortality in patients with hepatitis A infection in the United States

• Published in: Public health (London) Vol. 207; pp. 113 - 118
• Main Authors: Sobotka, L.A., Mumtaz, K., Hinton, A., Porter, K., Conteh, L.F.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-06-2022
• Subjects: Cirrhosis; Healthcare disparities; Healthcare utilization; Hepatitis A virus; Mortality; Vaccination; Cirrhosis; Hepatitis A virus; Healthcare disparities; Healthcare utilization; Mortality; Vaccination
• ISSN: 0033-3506; 1476-5616
• DOI: 10.1016/j.puhe.2022.04.002

Predictors of negative outcomes related to hepatitis A virus (HAV) need to be studied at a national level.
A retrospective analysis using the Nationwide Inpatient Sample (2002–2013) and Nationwide Readmission Database (2010–2014) was performed to evaluate the outcomes of hospitalized patients with HAV. The Nationwide Inpatient Sample and the Nationwide Readmission Database included a varying number of states during the studied time and reflect the range of implementation dates of the HAV vaccines. Multivariable analyses were fit to determine predictors of outcomes.
A total of 13,514 patients were admitted with HAV during the studied time. Thirty-day and 90-day readmission rates were 11.4% and 15%, respectively. Predictors of readmission, longer length of stay, and mortality included patients aged >60 years ([odds ratio [OR]: 1.02; 95% confidence interval [CI]: 1.001–1.03], [OR: 1.15; CI: 1.07–1.24], [OR: 4.06; 95% CI: 1.47–11.16], respectively), Medicare insurance ([OR:3.63; 95% CI: 2.18–6.03], [OR: 1.26; 95% CI: 1.17–1.37], [OR: 2.67; 95% CI: 1.18–6.04], respectively), and cirrhosis ([OR: 1.83; 95% CI: 1.05–3.21], [OR: 1.33; 95% CI: 1.20–1.47], [OR: 2.83; 95% CI: 1.14–7.05], respectively). Predictors of higher cost of admission included patients aged >60 years (OR: 1.32, 95% CI: 1.19–1.46), Hispanic (OR: 1.14; 95% CI: 1.05–1.24), Medicare insurance (OR: 1.22; 95% CI: 1.10–1.35), Medicaid insurance (OR: 1.10; 95% CI: 1.02–1.20), and cirrhosis (OR: 1.28; 95% CI: 1.11–1.46).
Patients at increased healthcare utilization and mortality should be prioritized for HAV vaccination.