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High rates of disability and health care use for older americans with cirrhosis
Date:1/10/2012

ssed patients' health status which included comorbidities, healthcare utilization and functional disability. Informal caregiving, measured by hours of care and associated cost, was also examined.

Study results reveal that patients with cirrhosis were more likely to be Hispanic, have less education, and have lower net worth. Older cirrhotic patients had worse self-reported health status and more medical comorbidities compared to those without the disease. Utilization of health care services, including physician visits, nursing home stays and hospitalizations, was more than double in those with cirrhosis compared to non-cirrhotic peers.

Greater functional disability was also significant among those with cirrhosis as measured by activities of daily living (ADL) and instrumental activities of daily living (IADL). Overall, 14% of cirrhotic patients could perform only one to two ADLs, such as dressing oneself, while 10% could perform none or only one IADL, such as housework. Given their inability to perform common everyday tasks, it is not surprising that informal caregiving was much higher in individuals with cirrhosistwice the number of informal caregiving hours per week at an annual cost of $4,700 per personcompared to their elderly counterparts without the disease.

"Our population-based study confirms that cirrhosis in the elderly poses a significant burden to patients and their caregivers in terms of health-related and economic costs," concludes Dr. Rakoski. "A greater focus on comprehensive delivery of patient care by involving caregivers and improving care coordination will help to optimize disease management for older cirrhotic patients." The authors recommend that future studies should investigate the impact of functional disability on outcomes such as hospital readmission and mortality in older patients with cirrhosis.


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