LIVER AND BILIARY DISEASE Epidemiology and economic burden of viral hepatitis: an observational population based study

Objective: To describe the epidemiology and estimate the health resource use of patients with viral hepatitis in Tayside, Scotland, using record linkage techniques. Design: A retrospective observational study. Setting: Liver disease database, Tayside, Scotland. Patients: All subjects resident in Tayside in the study period 1989–1999 and registered on the Epidemiology of Liver Disease in Tayside (ELDIT) database. Main outcome measures: Incidence and prevalence of known viral hepatitis in Tayside, survival of subjects diagnosed with viral hepatitis, and the health resource use with respect to hospital admissions compared with the general population. Results: There were 4992 patients identified with viral hepatitis in the study period 1989–1999; 86 were IgM positive anti-hepatitis A, 187 patients were hepatitis B surface antigen (HBsAg) positive, and 469 were anti-hepatitis C (HCV) positive. HCV and HBsAg seropositive patients were more likely to be hospitalised and stay in hospital longer, less likely to survive after six years, and used more drugs of potential abuse than the general population. There was an increase in cost per admission and per patient as a consequence of liver disease. Conclusions: A record linkage population based study of viral hepatitis allows outcomes to be identified and costed. Those at risk of viral hepatitis infection in the Tayside population should be informed about the future implication to their health and costs to society. The health service should investigate the cost effectiveness of vaccination and opportunity costs to the health service of viral hepatitis taking into consideration the increasing incidence and prevalence of disease.