Health Care Utilization and Associated Costs of Hepatitis A in Adults in a US Commercially Insured Population

Abstract

Objective

To examine the impact of acute hepatitis A on health care utilization and cost in a commercially insured population.

Study Design

This observational, retrospective cohort study used medical and pharmacy claims data from January 1, 2004 through October 31, 2009. A matched control group consisted of patients without hepatitis A during the study period. Descriptive statistics were used to assess differences between hepatitis A patients (cases) and controls.

Results

The case and control groups each contained 2331 patients. In the 12-month post-index period, 482 (20.7%) cases and 193 (8.3%; P < .0001) controls had inpatient (INP) hospitalizations (adjusted mean estimated costs [AMEC] $4433 and $1244 [P < .0001], respectively). Emergency department (ED) services occurred in 382 (16.4%) cases, versus 277 (11.9%; P < .0001) controls (AMEC $225 and $132 [P < .0001], respectively). The mean number of outpatient services (OUT) for cases was 21.5 (±22.1) versus 14.7 (±18.2) for controls, with AMEC $4132 and $2092, respectively. The mean number of physician visits was 9.1 (±9.9) and 5.5 (±7.4) for each group, respectively [AMEC $1025 vs. $577; P < .0001]. There were 20.13 (±24.1) and 19.37 (±24.5) pharmacy claims, with AMEC $1565 and $1115 (P < .0001), in cases and controls, respectively. Adjusted mean total estimated associated costs were $11,479 and $5323 (P < .0001), respectively. Multivariate regression results demonstrated that patients with hepatitis A have higher total medical costs even after adjusting for age, sex, comorbidities, pre-index cost, and hepatitis A vaccination.

Conclusions

Patients with hepatitis A had significantly higher health care resource utilization and costs during the 1-year post-index period, compared with controls.