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Gender and Racial Differences in Hospitalizations for Primary Biliary Cholangitis in the USA
Adeyinka Charles Adejumo1,2, Daud H Akhtar3, Brittany B Dennis4
1Department of Medicine, North Shore Medical Center, 81 Highland Ave., Salem, MA, 01970, USA. acadejumo@partners.org.
Insights
The US hospitalization rate for primary biliary cholangitis (PBC) increased from 2007-2014, disproportionately affecting females and Hispanics. Black patients experienced higher mortality rates for this liver disease.
Area of Science:
- Hepatology and Gastroenterology
- Public Health and Epidemiology
- Health Services Research
Background:
- The epidemiology of primary biliary cholangitis (PBC) hospitalizations in the USA, including prevalence, characteristics, and trends, is not well-defined.
- Understanding these factors is crucial for managing the disease burden and healthcare resource allocation.
Purpose of the Study:
- To analyze the trends, characteristics, and predictors of primary biliary cholangitis (PBC) hospitalizations in the United States from 2007 to 2014.
- To investigate disparities in hospitalization rates, mortality, length of stay, and costs among different demographic groups.
Main Methods:
- Utilized the National Inpatient Sample (NIS) database from 2007 to 2014.
- Identified primary PBC hospitalizations using ICD-9-CM codes.
- Calculated hospitalization rates per 100,000 population by gender and race, and analyzed predictors of mortality, charges, and length of stay.
Main Results:
- PBC hospitalizations increased from 1.7 to 2.5 per 100,000 population between 2007 and 2014.
- Hospitalization rates were higher in females and Hispanics compared to males and Whites, respectively.
- Black patients had higher mortality odds, and other racial minorities experienced longer hospital stays and higher charges compared to Whites.
Conclusions:
- The burden of primary biliary cholangitis hospitalizations in the USA has risen, with notable increases among females and Hispanic populations.
- Significant racial disparities exist, particularly higher mortality rates among Black patients.
- These findings highlight the need for targeted interventions and further research into health equity for PBC patients.
Background/Aim:
The prevalence, characteristics, burden and trends of primary biliary cholangitis (PBC) hospitalizations in the USA remain unclear.
Method:
We identified primary PBC hospitalizations from the National Inpatient Sample (NIS) 2007 through 2014 using ICD-9-CM codes. We calculated the rates and trends of hospitalization for PBC per 100,000 US population among each gender (males and females) and racial categories (Whites, Blacks, Hispanics and other racial minorities), and measured the predictors of hospitalization, and of mortality, charges and length of stay (LOS) among PBC hospitalizations.
Result:
There were 8460 (weighted: 41,191) PBC hospitalizations between 2007 and 2014. The mean national PBC hospitalization rate was 2.2 cases per 100,000 population (2.2/100,000), increasing from 1.7/100,000 (2007) to 2.5/100,000 (2014). From 2007 to 2014, the in-hospital mortality and LOS were unchanged while the charges increased from $65,993 to $73,093 ($225 million to $447 million overall expenses). Compared to Whites, the PBC hospitalization rate was 12% higher among Hispanics (RR: 1.12 [1.09-1.16]), 53% lower in Blacks (RR: 0.47 [0.45-0.49]) and 5% lower among other racial minorities (0.95 [0.91-0.99]). The rate was higher among females (RR:4.02 [3.93-4.12]) compared to males. On multivariate analysis, Blacks and other racial minorities, respectively, had higher odds of mortality (AOR: 1.47 [1.03-2.10] and 1.33 [0.96-1.84]), while other racial minorities had longer LOS (7.0 vs. 5.6 days) and higher hospital charges ($48,984 vs. $41,495) when compared to Whites.
Conclusion:
The hospitalization rate and burden of PBC in the USA have increased disproportionately among females and Hispanics with higher mortality in Blacks.
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