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High Rates of Disability and Health Care

High Rates of Disability and Health Care

Photo: Patient

Cirrhosis is a chronic condition that causes the liver to slowly deteriorate, with scar tissue replacing healthy tissue and impairing liver function. Studies have shown that non-alcoholic fatty liver disease (NAFLD) — ranging in severity from fatty liver to non-alcoholic steatohepatitis (NASH) to cirrhosis — has become the most prevalent cause of chronic liver disease worldwide, affecting up to 30 per cent of the general population and found in 75 per cent of obese individuals. The Action Plan for Liver Disease Research estimates that 5.5 million Americans have chronic liver disease or cirrhosis, which is one of the most expensive digestive diseases costing 1.6 billion Dollars annually in healthcare costs and lost work days.

"With the obesity epidemic contributing to a rise in NAFLD cases along with the aging HCV patient population, cirrhosis among the elderly is expected to become increasingly prevalent," says Doctor Mina Rakoski. "Therefore, understanding the health and economic burden on older cirrhotic patients, their caregivers, and the health system is extremely important."

Rakoski and colleagues identified 317 patients with cirrhosis and 951 age-matched individuals without the disease from the Health and Retirement Study and Medicare claims files. Researchers assessed patients' health status and informal care giving, measured by hours of care and associated cost.

Study results reveal that patients with cirrhosis were more likely to be Hispanic, have less education, and have lower net worth. Older cirrhotic patients had worse self-reported health status and more medical co-morbidities compared to those without the disease. Utilization of health care services, including physician visits, nursing home stays and hospitalisations, was more than double in those with cirrhosis compared to non-cirrhotic peers.

Greater functional disability was also significant among those with cirrhosis as measured by activities of daily living and instrumental activities of daily living. Given their inability to perform common everyday tasks, it is not surprising that informal care giving was much higher in individuals with cirrhosis — twice the number of informal care giving hours per week at an annual cost of 4,700 Dollars per person — compared to their elderly counterparts without the disease.

"Our population-based study confirms that cirrhosis in the elderly poses a significant burden to patients and their caregivers in terms of health-related and economic costs," says Rakoski. "A greater focus on comprehensive delivery of patient care by involving caregivers and improving care coordination will help to optimize disease management for older cirrhotic patients."

MEDICA.de; Source: University of Michigan