Using the 10th and 90th percentile hourly national wage for a hom

Using the 10th and 90th percentile hourly national wage for a home health aide, annual cost of Selumetinib solubility dmso informal caregiving

ranged from US $3700 to US $6700 for patients with cirrhosis and from US $1600 to US $2900 for patients without cirrhosis. In this nationally representative sample of older Americans, we found that individuals with cirrhosis had significantly worse health status and greater functional disability compared to those without cirrhosis, requiring nearly twice the amount of informal caregiving at an annual societal cost of approximately US $4700 per individual. Nearly 20% of subjects with cirrhosis experienced severe functional decline (loss of two or more ADLs) over a median of approximately 2 years, more than doubling that of age-matched individuals without cirrhosis.

As the incidence of nonalcoholic fatty liver disease increases and the population infected with hepatitis C virus BMS-907351 solubility dmso ages, cirrhosis among the elderly will become increasingly prevalent and is expected to impose a significant burden to patients and their caregivers. In addition to the potential burden to caregivers, individuals with cirrhosis also strain the health care system. Annually, cirrhosis results in 50,000 hospitalizations22; of those who survive hospitalization, approximately 20% are readmitted within 30 days.23 Our findings show that more than two-thirds of individuals with cirrhosis report being admitted to the hospital within the prior 2 years, an incidence twice that of age-matched individuals without cirrhosis. Moreover, fewer than one-quarter of individuals with cirrhosis received home health care services after hospital see more discharge, indicating a potentially lost opportunity for improved

care transitions. In other diseases, improving patient and caregiver knowledge about chronic disease management and integrating caregivers in the health care process have been shown to significantly decrease hospital admission rates.24, 25 Our findings suggest that applying these concepts and services among patients with cirrhosis has the potential to result in significant cost savings. It is important to emphasize this study compared subjects with cirrhosis to age-matched individuals, not healthy controls. As expected with advancing age, individuals in the comparison group had several comorbidities (e.g., arthritis in 62%, cardiac disease in 31%, diabetes in 18%, and cancer in 16%; Table 2), all of which can be independently associated with significant functional decline and cost. Thus, the current study highlights the incremental disability, cost, and caregiver burden of cirrhosis, even relative to other serious chronic illnesses.

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