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Introduction: Hepatitis C virus (HCV) infection is the most common chronic blood-borne pathogen in the United States (US). Nearly 2% or 3.5 million persons in the United States are affected with HCV. It is one of the most common indication for liver transplantation and it is associated with liver-comorbidities such as higher risk of developing liver cirrhosis and hepatocellular carcinoma (HCC), accounting for an estimate of 400,000 liver-related deaths globally in 2015. Other chronic liver diseases (CLD) such as hepatitis B, alcoholic liver disease (ALD), alcoholic fatty liver (AFL), nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), and biliary cirrhosis also play an important role among Americans. Methods: This is a retrospective, cross-sectional study that was conducted to analyze the demographic characteristics and to estimate the percentage of national outpatient and emergency department visits for children and adults with Hepatitis C and other CLD. Data was extracted from the National Hospital Ambulatory Medical Care Survey (NHAMC) and National Ambulatory Medical Care Survey (NAMCS). Both databases are two of the largest national studies involving physicians’ self-report of preventive health care services within the primary care physician office visit and hospital visit. This study included all adults (between 18 and 75 years old) in the NHAMCS and NAMCS database with any diagnosis of HCV infection and other CLD. The main objective of the present study was to determine the demographic trends among HCV infection and other CLD patients by analyzing trends in gender, age, race, ethnicity, insurance status, and alcohol using US national representative databases. Results: The results from this study indicate new trends of HCV-related and other CLD-related ambulatory care visits on the US healthcare system from 2011 to 2016. The most important findings in this study were the differences in health coverage use in physician offices (NAMCS) and hospitals (NHAMCS). Both HCV and other CLD-related ambulatory care visits had a higher percentage of private insurance recipients in physician offices visits while the percentage was much higher for Medicaid recipients in hospital visits. Moreover, the results in this study highlight demographic characteristics for liver disease inhhh the US population. We observed higher percentages in whites, non-Hispanics, and private insurance in both HCV and other CLD-related ambulatory care visits. Conclusion: The study concludes that HCV-related and other CLD-related ambulatory care visits are generally increasing, and that more visits are occurring among whites and Medicaid patients over time. The strength of the NAMCS and NHAMCS databases are in the reliability of its measures, collected year to year, providing a longitudinal perspective from which change can be tracked and possibly linked to policy change. Policy-makers should be aware that liver disease-related ambulatory care visits are increasingly paid through Medicaid insurance, which may increase the already high burden on the public health care system in the future. |
