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Article Dans Une Revue Clinical Diabetes and Endocrinology Année : 2024

Factors associated with high costs of patients with metabolic dysfunction-associated steatotic liver disease: an observational study using the French CONSTANCES cohort

Valérie Paradis
  • Fonction : Auteur
Bernard van Beers
  • Fonction : Auteur
Catherine Postic
  • Fonction : Auteur
Cédric Laouénan
  • Fonction : Auteur
Stanislas Pol
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Laurent Castéra
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Jean-François Gautier
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Sebastien Czernichow
  • Fonction : Auteur
Anais Vallet-Pichard
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Etienne Larger
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Lawrence Serfaty
  • Fonction : Auteur
Dominique Valla
  • Fonction : Auteur
Isabelle Durand Zaleski
  • Fonction : Auteur
  • PersonId : 1004426

Résumé

Abstract Background & aims Despite its high prevalence in the western world metabolic dysfunction-associated steatotic liver disease (MASLD) does not benefit from targeted pharmacological therapy. We measured healthcare utilisation and identified factors associated with high-cost MASLD patients in France. Methods The prevalent population with MASLD (including non-alcoholic steatohepatitis) in the CONSTANCES cohort, a nationally representative sample of 200,000 adults aged between 18 and 69, was linked to the French centralised national claims database (SNDS). Study participants were identified by the fatty liver index (FLI) over the period 2015–2019. MASLD individuals were classified according as “high-cost” (above 90th percentile) or “non-high cost” (below 90th percentile). Factors significantly associated with high costs were identified using a multivariate logistic regression model. Results A total of 14,437 predominantly male (69%) participants with an average age of 53 ± SD 12 years were included. They mainly belonged to socially deprived population groups with co-morbidities such as diabetes, high blood pressure, mental health disorders and cardiovascular complications. The average expenditure was €1860 ± SD 4634 per year. High-cost MASLD cost €10,863 ± SD 10,859 per year. Conditions associated with high-cost were mental health disorders OR 1.79 (1.44–2.22), cardiovascular diseases OR 1.54 (1.21–1.95), metabolic comorbidities OR 1.50 (1.25–1.81), and respiratory disease OR 1.50 (1.11–2.00). The 10% high-cost participants accounted for 58% of the total national health care expenditures for MASLD. Conclusion Our results emphasize the need for comprehensive management of the comorbid conditions which were the major cost drivers of MASLD. Graphical Abstract
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hal-04566657 , version 1 (02-05-2024)

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Arnaud Nze Ossima, Angélique Brzustowski, Valérie Paradis, Bernard van Beers, Catherine Postic, et al.. Factors associated with high costs of patients with metabolic dysfunction-associated steatotic liver disease: an observational study using the French CONSTANCES cohort. Clinical Diabetes and Endocrinology, 2024, 10 (1), pp.9. ⟨10.1186/s40842-023-00163-4⟩. ⟨hal-04566657⟩

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