Burden of Cirrhosis on Older Americans and Their Families

• DOI: 10.1002/hep.24616
• Publication Date: 2011-08-20T09:31:04Z
• Authors: Mina O. Rakoski; Ryan J. McCammon; John D. Piette; Theodore J. Iwashyna; Jorge A. Marrero; Anna S. Lok; Kenneth M. Langa; Michael L. Volk
• Keywords: Liver Cirrhosis; Male; 0301 basic medicine; Databases, Factual; Health Status; Black People; Comorbidity; Medicare; Disability Evaluation; 03 medical and health sciences; Cost of Illness; Health Sciences; Prevalence; Humans; Prospective Studies; Aged; Retirement; Medicaid; Incidence; Health Care Costs; Hispanic or Latino; 3. Good health; Caregivers; Internal Medicine and Specialties; Female

Prevalence of cirrhosis among older adults is expected to increase; therefore, we studied the health status, functional disability, and need for supportive care in a large national sample individuals with cirrhosis. A prospective cohort was identified within longitudinal, nationally representative Health Retirement Study. Cirrhosis cases were linked Medicare data via ICD–9–CM (International Classification Diseases, Ninth Revision, Clinical Modification) codes compared an age–matched without Two primary outcome domains assessed: (1) patients' status (perceived comorbidities, utilization, disability as determined by activities daily living instrumental living), (2) informal caregiving (hours provided caregiver associated cost). Adjusted negative binomial regression used assess association between disability. total 317 951 comparators identified. Relative comparison group, had worse self–reported more significantly services (hospitalizations, nursing home stays, physician visits; P < 0.001 all bivariable comparisons). They also greater ( despite adjustment covariates such comorbidities utilization. Individuals received than twice number hours per week 0.001), at annual cost US $4700 person. Conclusion: Older Americans have high rates caregiving. Improved coordination support necessary optimize management this frail population. (Hepatology 2012;55:184–191)