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The feasibility of studying drug-induced acute hepatitis with use of Medicaid data
J L Carson1, B L Strom, A Duff
1Division of General Internal Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08903.
Abstract:
To determine the feasibility of the use of Medicaid data to study drug-induced acute liver disease, we reviewed the medical records of 414 patients receiving Medicaid, age 20 or older, with an ICD-9-CM inpatient billing code consistent with acute hepatitis. Of the patients whose records were reviewed, 15.9% were alcoholics, 31.9% had acute hepatitis A or B, 13.5% were intravenous drug users, 8.2% had acute cholecystitis or choledocholithiasis, and 4.1% had received a blood transfusion within the previous 6 months. No diagnosis of liver disease was found in 10.6% of the patients, and 5.7% had chronic liver disease. Of the 169 patients with idiopathic acute liver disease identified, many had very mild liver disease and were hospitalized for reasons other than liver disease. We conclude that Medicaid billing data has high reliability and validity for the diagnosis of acute liver disease. However, primary medical records are essential for the study of drug-induced hepatitis, to be able to exclude other causes of liver disease, and to obtain information not included in the computer data.
Insights
Medicaid billing data can reliably diagnose acute liver disease. However, studying drug-induced hepatitis requires reviewing primary medical records to exclude other causes and gather detailed information.
Area of Science:
- Hepatology
- Public Health
- Health Informatics
Background:
- Acute liver disease diagnosis can be challenging.
- Medicaid data is a potential resource for epidemiological studies.
- Drug-induced liver injury (DILI) requires accurate diagnostic methods.
Purpose of the Study:
- To assess the feasibility of using Medicaid data for studying drug-induced acute liver disease.
- To evaluate the reliability and validity of Medicaid billing data for acute liver disease diagnosis.
Main Methods:
- Retrospective review of 414 Medicaid patient records (age ≥ 20).
- Patients had ICD-9-CM inpatient billing codes for acute hepatitis.
- Analysis of diagnoses including alcoholism, viral hepatitis, drug use, and other liver conditions.
Main Results:
- Medicaid billing data showed high reliability and validity for acute liver disease diagnosis.
- Identified causes included alcoholism (15.9%), viral hepatitis (31.9%), and IV drug use (13.5%).
- 169 patients had idiopathic acute liver disease, some with mild cases or hospitalized for other reasons.
Conclusions:
- Medicaid billing data is a reliable tool for identifying acute liver disease.
- Primary medical records are crucial for studying drug-induced hepatitis.
- Detailed patient records are necessary to exclude alternative diagnoses and capture comprehensive data.