Burden of cirrhosis on older Americans and their families: Analysis of the health and retirement study
dc.contributor.author | Rakoski, Mina O. | en_US |
dc.contributor.author | McCammon, Ryan J. | en_US |
dc.contributor.author | Piette, John D. | en_US |
dc.contributor.author | Iwashyna, Theodore J. | en_US |
dc.contributor.author | Marrero, Jorge A. | en_US |
dc.contributor.author | Lok, Anna Suk-Fong | en_US |
dc.contributor.author | Langa, Kenneth M. | en_US |
dc.contributor.author | Volk, Michael L. | en_US |
dc.date.accessioned | 2012-01-05T22:06:15Z | |
dc.date.available | 2013-03-04T15:29:55Z | en_US |
dc.date.issued | 2012-01 | en_US |
dc.identifier.citation | Rakoski, Mina O.; McCammon, Ryan J.; Piette, John D.; Iwashyna, Theodore J.; Marrero, Jorge A.; Lok, Anna S.; Langa, Kenneth M.; Volk, Michael L. (2012). "Burden of cirrhosis on older Americans and their families: Analysis of the health and retirement study ." Hepatology 55(1): 184-191. <http://hdl.handle.net/2027.42/89512> | en_US |
dc.identifier.issn | 0270-9139 | en_US |
dc.identifier.issn | 1527-3350 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/89512 | |
dc.description.abstract | 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 of individuals with cirrhosis. A prospective cohort of individuals with cirrhosis was identified within the longitudinal, nationally representative Health and Retirement Study. Cirrhosis cases were identified in linked Medicare data via ICD‐9‐CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes and compared to an age‐matched cohort without cirrhosis. Two primary outcome domains were assessed: (1) patients' health status (perceived health status, comorbidities, health care utilization, and functional disability as determined by activities of daily living and instrumental activities of daily living), and (2) informal caregiving (hours of caregiving provided by a primary informal caregiver and associated cost). Adjusted negative binomial regression was used to assess the association between cirrhosis and functional disability. A total of 317 individuals with cirrhosis and 951 age‐matched comparators were identified. Relative to the comparison group, individuals with cirrhosis had worse self‐reported health status, more comorbidities, and used significantly more health care services (hospitalizations, nursing home stays, physician visits; P < 0.001 for all bivariable comparisons). They also had greater functional disability ( P < 0.001 for activities of daily living and instrumental activities of daily living), despite adjustment for covariates such as comorbidities and health care utilization. Individuals with cirrhosis received more than twice the number of informal caregiving hours per week ( P < 0.001), at an annual cost of US $4700 per person. Conclusion: Older Americans with cirrhosis have high rates of disability, health care utilization, and need for informal caregiving. Improved care coordination and caregiver support is necessary to optimize management of this frail population. (H EPATOLOGY 2012;55:184–191) | en_US |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.title | Burden of cirrhosis on older Americans and their families: Analysis of the health and retirement study | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Institute for Social Research, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Department of Internal Medicine, Division of Gastroenterology, University of Michigan Health System, 3912 Taubman Center, SPC 5362, Ann Arbor, MI 48109‐5362 | en_US |
dc.contributor.affiliationother | VA Ann Arbor Healthcare System Center for Clinical Management Research, Ann Arbor, MI | en_US |
dc.identifier.pmid | 21858847 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/89512/1/24616_ftp.pdf | |
dc.identifier.doi | 10.1002/hep.24616 | en_US |
dc.identifier.source | Hepatology | en_US |
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dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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