Charges for Alcoholic Cirrhosis Exceed All Other Etiologies of Cirrhosis Combined: A National and State Inpatient Survey Analysis

  • A. Sidney BarrittIVEmail author
  • Yue Jiang
  • Monica Schmidt
  • Paul H. Hayashi
  • Ramon Bataller
Original Article



Inpatient charges for patients with cirrhosis are substantial. We aimed to examine trends in inpatient charges among patients with cirrhosis to determine the drivers of healthcare expenditures. We hypothesized that alcoholic cirrhosis (AC) was a significant contributor to overall expense.


We performed a retrospective analysis of the Health Care Utilization Project Nationwide Inpatient Sample Database 2002–2014 (annual cross-sectional data) and New York and Florida State Inpatient Databases 2010–2012 (longitudinal data). Adult patients with cirrhosis of the liver were categorized as AC versus all other etiologies of cirrhosis combined. Patient characteristics were analyzed using ordinary least squares regression modeling. A random effects model was used to evaluate 30-day readmissions.


In total, 1,240,152 patients with cirrhosis were admitted between 2002 and 2014. Of these, 567,510 (45.8%) had a diagnosis of AC. Total charges for AC increased by 95.7% over the time period, accounting for 59.9% of all inpatient cirrhosis-related charges in 2014. Total aggregate charges for AC admissions were $28 billion and increased from $1.4B in 2002 to $2.8B by 2014. In the NIS and SID, patients with AC were younger, white and male. Readmission rates at 30, 60, and 90 days were all higher among AC patients.


Inpatient charges for cirrhosis care are high and increasing. Alcohol-related liver disease accounts for more than half of these charges and is driven by sheer volume of admissions and readmissions of the same patients. Effective alcohol addictions therapy may be the most cost-effective way to substantially reduce inpatient cirrhosis care expenditures.


Alcohol Charges Costs Cirrhosis Burden 



Alcoholic cirrhosis


Hepatitis C


Nonalcoholic fatty liver disease


Nationwide Inpatient Sample


Healthcare Cost and Utilization Project


Agency for Healthcare Research and Quality


State Inpatient Database


International Classification of Diseases, 9th Revision, Clinical Modification


Nonalcohol-related cirrhosis


Compliance with ethical standards

Conflict of interest

The authors have no relevant conflicts to disclose.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • A. Sidney BarrittIV
    • 1
    Email author
  • Yue Jiang
    • 2
  • Monica Schmidt
    • 1
    • 3
  • Paul H. Hayashi
    • 1
  • Ramon Bataller
    • 1
    • 4
  1. 1.Division of Gastroenterology and Hepatology, UNC Liver CenterThe University of North Carolina at Chapel HillChapel HillUSA
  2. 2.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  3. 3.Center for Outcomes Research and EvaluationCarolinas Healthcare SystemCharlotteUSA
  4. 4.Center for Liver DiseasesUniversity of Pittsburgh Medical CenterPittsburghUSA

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