Modeling the impact of COVID‐19 pandemic‐driven increases in alcohol consumption on health outcomes and hospitalization costs in the United States

Barbosa, Carolina; Dowd, William N.; Neuwahl, Simon; Rehm, Jürgen; Imtiaz, Sameer; Zarkin, Gary A.

doi:10.1111/add.16018

Cited by 13 publications

(13 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The significant increase in alcohol use during the pandemic had immense implications from a healthcare perspective. A US model projecting increased alcohol use from the first year of the pandemic over 5 years resulted in a loss of 79 000 life years, 332 000 quality‐adjusted life years, and an additional $5.4 billion in healthcare costs, of which $3.0 billion were related to cirrhosis hospitalizations 20 …”

Section: Discussionmentioning

confidence: 99%

A nationwide study of liver disease hospitalizations during the coronavirus pandemic in the United States

Sedarous

Youssef

Adekunle

et al. 2023

J of Gastro and Hepatol

View full text Add to dashboard Cite

Background and Aim The impact of the Coronavirus disease‐2019 (COVID‐19) pandemic on patients with liver disease is not well described at the population level in the United States. We used the largest, nationwide inpatient dataset to describe inpatient liver disease outcomes in the United States during the first year of the pandemic (2020) using 2018 and 2019 as comparator years. Methods Using the National Inpatient Sample (2018–2020), we explored year‐to‐year and 2020 month‐to‐month trends in hospitalizations, length of stay, and inpatient mortality for liver‐related complications including cirrhosis, alcohol‐associated liver disease (ALD) and alcoholic hepatitis using regression modeling. We reported relative change (RC) in the study period. Results Decompensated cirrhosis hospitalizations decreased in 2020 compared with 2019 (RC: −2.7%, P < 0.001) while all‐cause mortality increased by 15.5% (P < 0.001). Hospitalizations for ALD increased compared with pre‐pandemic years (RC: 9.2%, P < 0.001) with a corresponding increase in mortality in 2020 (RC 25.2%, P = 0.002). We observed an increase in liver transplant surgery mortality during the peak months of the pandemic. Importantly, mortality from COVID‐19 was higher among patients with decompensated cirrhosis (adjusted odds ratio [OR] 1.72, 95% confidence interval [CI] [1.53–1.94]), Native Americans (OR 1.76, 95% CI [1.53–2.02]), and patients from lower socioeconomic groups. Conclusions Cirrhosis hospitalizations decreased in 2020 compared with pre‐pandemic years but were associated with higher all‐cause mortality rates particularly in the peak months of the COVID‐19 pandemic. In‐hospital COVID‐19 mortality was higher among Native Americans, patients with decompensated cirrhosis, chronic illnesses, and those from lower socioeconomic groups.

show abstract

Section: Discussionmentioning

confidence: 99%

A nationwide study of liver disease hospitalizations during the coronavirus pandemic in the United States

Sedarous

Youssef

Adekunle

et al. 2023

J of Gastro and Hepatol

View full text Add to dashboard Cite

show abstract

“…We used a validated individual‐level simulation model of the long‐term drinking patterns of US adults with AUD diagnoses (Barbosa et al, 2019, 2023). Individual‐level models (or microsimulation models) simulate one individual at a time and keep track of each simulated individual's history (Neumann et al, 2016).…”

Section: Methodsmentioning

confidence: 99%

“…Based on the nature of the alcohol‐related conditions, each condition was assumed to be acute (i.e., lasting 1 year or less), long‐term (lasting an average of 5 years), or chronic (lasting for the remainder of one's lifetime) in the model. Additional information is available in the Supporting Information and in Barbosa et al (2023).…”

Section: Methodsmentioning

confidence: 99%

Modeling the impact of a long‐term horizon and multiple treatment episodes on estimates of the cost‐effectiveness of alcohol treatment in the United States

Barbosa,

Dowd,

Karriker‐Jaffe

et al. 2023

Alcohol: Clinical and Experimental Research

Self Cite

View full text Add to dashboard Cite

BackgroundMost clinical studies of alcohol use disorder (AUD) treatment have short follow‐up periods, underestimating the full benefits of alcohol treatment. Furthermore, clinical studies only consider one treatment cycle and do not account for the need for multiple episodes to treat a chronic recurrent condition.MethodsA validated microsimulation model of the long‐term drinking patterns of people with AUD in the United States simulated 10,000 individuals resembling those from a large clinical trial. The model was used to assess the impact of (1) 1‐year, 5‐year, and lifetime horizon on alcohol treatment cost‐effectiveness estimates and (2) no, one, two, four, and unlimited additional treatment episodes on alcohol treatment cost‐effectiveness estimates. Model outcomes included healthcare costs, crime costs, labor market productivity, life expectancy, quality‐adjusted life years (QALYs), alcohol‐related hospitalizations, and deaths. Cost‐effectiveness analyses were conducted for two perspectives: a healthcare perspective that included costs from hospitalization and AUD treatment, and a broader societal perspective that also included crime costs and productivity.ResultsThe incremental cost per additional QALY gained for alcohol treatment compared with no treatment decreased from $55,590 after 1 year to $78 when healthcare costs and QALYs were tracked over the lifetime, that is, treatment became more cost effective. Treatment was cost saving for any time frame when the impacts on crime and labor productivity were also accounted for in a societal perspective. Access to multiple treatment episodes dominated (i.e., it was more effective and less costly) than no‐treatment and one‐episode scenarios. From a healthcare perspective, incremental costs per additional QALY for increasing from a maximum of two to four treatment episodes was $499 and from four to unlimited episodes was $5049. The unlimited treatment scenario dominated all others from a societal perspective. Results were robust in sensitivity analyses.ConclusionsA long‐term perspective and multiple episodes of alcohol treatment improve cost‐effectiveness estimates. When societal impacts are included, alcohol treatment is cost saving. Results support the value of alcohol treatment.

show abstract

“…As already mentioned, many studies have confirmed that an increase in alcohol consumption in a short-term period during the COVID-19 pandemic can cause long-term ArLD-related morbidity, hospitalizations and mortality[ 13 - 15 , 17 , 27 ], and that abnormal liver biochemical tests are often closely related to the severity and prognosis of patients with COVID-19[ 28 ].…”

Section: Alcohol and Liver Injurymentioning

confidence: 99%

“…A simulation model of the long-term drinking patterns of people with lifetime AUD has revealed that if the increase in alcohol consumption registered in the United States in the first year of the pandemic continues with similar characteristics, alcohol-related mortality, morbidity and associated costs will increase considerably over the next 5 years[ 17 ]. These observations are a red flag for the necessary improvement in screening for high-risk alcohol use and optimization of early treatment of abuse or misuse and its physical and psychological consequences.…”

Section: Introductionmentioning

confidence: 99%

Alcohol use disorder and liver injury related to the COVID-19 pandemic

Marano¹,

Traversi²,

Gaetani³

et al. 2022

World J Hepatol

View full text Add to dashboard Cite

Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components. Alcohol is a hepatotoxin whose metabolism creates profound alterations within the hepatocyte. The liver is the central organ in the metabolism of alcohol, a process that also involves other organs and tissues such as the brain, heart and muscles, but the most relevant organ is the liver. The anatomopathological alterations in the liver associated with the prolonged use of alcohol range from the simple accumulation of neutral fats in the hepatocytes, to cirrhosis and hepatocellular carcinoma. Alcohol abuse frequently leads to liver disease such as steatosis, steatohepatitis, fibrosis, cirrhosis, and tumors. Following the spread of coronavirus disease 2019 (COVID-19), there was an increase in alcohol consumption, probably linked to the months of lockdown and smart working. It is known that social isolation leads to a considerable increase in stress, and it is also recognized that high levels of stress can result in an increase in alcohol intake. Cirrhotic patients or subjects with liver cancer are immunocompromised, so they may be more exposed to COVID-19 infection with a worse prognosis. This review focuses on the fact that the COVID-19 pandemic has made the emergence of alcohol-induced liver damage a major medical and social problem.

show abstract

Modeling the impact of COVID‐19 pandemic‐driven increases in alcohol consumption on health outcomes and hospitalization costs in the United States

Cited by 13 publications

References 61 publications

A nationwide study of liver disease hospitalizations during the coronavirus pandemic in the United States

A nationwide study of liver disease hospitalizations during the coronavirus pandemic in the United States

Modeling the impact of a long‐term horizon and multiple treatment episodes on estimates of the cost‐effectiveness of alcohol treatment in the United States

Alcohol use disorder and liver injury related to the COVID-19 pandemic

Contact Info

Product

Resources

About