Patterns of service utilisation within Australian hepatology clinics: High prevalence of advanced liver disease

El-Atem, Nathan A., Wojcik, Kyle, Horsfall, Leigh, Irvine, Katharine M., Johnson, Tracey, McPhail, Steven M., & Powell, Elizabeth E. (2016) Patterns of service utilisation within Australian hepatology clinics: High prevalence of advanced liver disease. Internal Medicine Journal, 46(4), pp. 420-426.

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Accepted Article Abstract Background: Liver diseases in Australia are estimated to affect 6 million people with a societal cost of $51 billion annually. Information about utilization of specialist hepatology care is critical in informing policy makers about the requirements for delivery of hepatology-related health care. Aims: This study examined etiology and severity of liver disease seen in a tertiary hospital hepatology clinic, as well as resource utilisation patterns. Methods: A longitudinal cohort study included consecutive patients booked in hepatology outpatient clinics during a 3 month period. Subsequent outpatient appointments for these patients over the following 12 months were then recorded. Results: During the initial 3 month period 1471 appointments were scheduled with a hepatologist, 1136 of which were attended. 21% of patients were “new cases”. Hepatitis B (HBV) was the most common disease etiology for new cases (37%). Advanced disease at presentation varied between etiology, with HBV (5%), Hepatitis C (HCV) (31%), non-alcoholic fatty liver disease (NAFLD) (46%) and alcoholic liver disease (ALD) (72%). Most patients (83%) attended multiple hepatology appointments, and a range of referrals patterns for procedures, investigations and other specialty assessments were observed. Conclusions: There is a high prevalence of HBV in new case referrals. Patients with HCV, NAFLD and ALD have a high prevalence of advanced liver disease at referral, requiring ongoing surveillance for development of decompensated liver disease and liver cancer. These findings that describe patterns of health service utilisation among patients with liver disease provide useful information for planning sustainable health service provision for this clinical population

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ID Code: 92682
Item Type: Journal Article
Refereed: Yes
Keywords: Liver, Health Resources, Tertiary Healthcare, Ambulatory Care
DOI: 10.1111/imj.13008
ISSN: 1445-5994
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Copyright Owner: Wiley-Blackwell Publishing Asia 2016
Deposited On: 11 Feb 2016 05:08
Last Modified: 13 Jun 2016 03:27

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