Journal article
Health care burden and mortality of acute on chronic liver failure in Thailand: a nationwide population-based cohort study
- Abstract:
- Background Accurate population-based data are required concerning the rate, economic impact, and long-term outcome from acute on chronic liver failures (ACLF) in hospitalized patients with cirrhosis. We aimed to discover time trends for the epidemiology, economic burden, and mortality of ACLF in Thailand. Methods We conducted a nationwide, population-based, cohort study which involved all hospitalized patients with cirrhosis in Thailand during the period between 2009 and 2013, with data from the National Health Security Office. ACLF was defined by two or more extrahepatic organ failures in patients with cirrhosis. Primary outcomes were trends in hospitalizations, hospital costs, together with inpatient mortality. Results The number of ACLF hospitalizations in Thailand doubled between 3185 in 2009 and 7666 in 2013. The average cost of each ACLF hospitalization was 3.5-fold higher than for cirrhosis (USD 1893 versus USD 519). The hospital is paid using a diagnosis-related group (DRG) payment system that is only 15% of the average treatment costs (USD 286 from USD 1893). The in-hospital fatality rate was 51% for ACLF while the additional fatality rate was 85% up to 1 year. The ACLF organ failure trends indicated sepsis with septic shock and renal failure as the majority proportion. Age, the number and types of organ failure and male sex were predictors of ACLF death. Conclusions and relevance Cirrhosis and ACLF both represent substantial and increasing health and economic burdens for Thailand. These data can assist national health care policy stakeholders to target high-risk patients with cirrhosis for care.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 741.9KB, Terms of use)
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- Publisher copy:
- 10.1186/s12913-022-07574-6
Authors
- Publisher:
- BioMed Central
- Journal:
- BMC Health Services Research More from this journal
- Volume:
- 22
- Article number:
- 156
- Publication date:
- 2022-02-07
- Acceptance date:
- 2022-02-01
- DOI:
- EISSN:
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1472-6963
- ISSN:
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1472-6963
- Pmid:
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35125103
- Language:
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English
- Keywords:
- Pubs id:
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1241377
- Local pid:
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pubs:1241377
- Deposit date:
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2022-07-20
- ARK identifier:
Terms of use
- Copyright holder:
- Chirapongsathorn et al.
- Copyright date:
- 2022
- Rights statement:
- Copyright © 2022 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Licence:
- CC Attribution (CC BY)
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