OBJECTIVES

Hepatitis A is an infection of the liver caused by hepatitis A virus. It is usually spread when a person ingests faecal matter from contact with contaminated objects, food, or drinks. An outbreak occurred within men who have sex with men (MSM) from mid-2016 to 2018. Using Hospital Episode Statistics data (HES) we sought to analyse the direct secondary care burden of coded hepatitis A cases in England from 2017-2019.

METHODS

Using HES from 1^st January 2017 – 31^st December 2019; all non-elective admissions, patient counts, bed days, and tariff costs with primary or secondary ICD-10 code related to hepatitis A (B15 ‘Acute hepatitis A’) were extracted for all ages. From these data, we calculated mean length of stay (LoS) and mean cost per admission (CpA).

RESULTS

In 2017, 900 hepatitis A admissions were recorded for 770 patients. This resulted in 4,620 bed days and total hospital costs of £1,705,172. The mean LoS was 5.1 days and mean CpA was £1,185. Males accounted for 71% admissions, 64% of bed days and 72% of hospital costs.

In 2018, 735 hepatitis A admissions were recorded for 585 patients, resulting in 3,625 bed days and costs of £1,475,183. Mean LoS was 4.9 days and mean CpA was £2,007. Males accounted for 50% admissions, 57% of bed days and 56% of hospital costs.

In 2019, 795 hepatitis A admissions were recorded for 630 patients, resulting in 4,630 bed days and costs of £1,778,127. Mean LoS was 5.8 days and mean CpA was £2,237. Males accounted for 48% admissions, 63% of bed days and 61% of hospital costs.

CONCLUSIONS

Hepatitis A can have a substantial impact on the healthcare system even before considering primary care and societal burden. Prevention through vaccination, particularly in males, could result in considerable savings for the NHS due to the higher associated costs.