Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan-Feb;140(1):115-124.
doi: 10.1177/00333549241260252. Epub 2024 Jul 26.

Regional Differences in Hepatitis C-Related Hospitalization Rates, United States, 2012-2019

Megan G Hofmeister  1 , Yuna Zhong  1 , Anne C Moorman  1 , Eyasu H Teshale  1 , Christina R Samuel  1 , Philip R Spradling  1
Affiliations

Regional Differences in Hepatitis C-Related Hospitalization Rates, United States, 2012-2019

Megan G Hofmeister et al. Public Health Rep. 2025 Jan-Feb.

Abstract

Objectives: In the United States, hepatitis C is the most commonly reported bloodborne infection. It is a leading cause of liver cancer and death from liver disease and imposes a substantial burden of hospitalization. We sought to describe regional differences in hepatitis C virus (HCV)-related hospitalizations during 2012 through 2019 to guide planning for hepatitis C elimination.

Methods: We analyzed discharge data from the National Inpatient Sample for 2012 through 2019. We considered hospitalizations to be HCV-related if (1) hepatitis C was the primary diagnosis or (2) hepatitis C was any secondary diagnosis and the primary diagnosis was a liver disease-related condition. We analyzed demographic and clinical characteristics of HCV-related hospitalizations and modeled the annual percentage change in HCV-related hospitalization rates, nationally and according to the 9 US Census Bureau geographic divisions.

Results: During 2012-2019, an estimated 553 900 HCV-related hospitalizations occurred in the United States. The highest hospitalization rate (34.7 per 100 000 population) was in the West South Central region, while the lowest (17.6 per 100 000 population) was in the West North Central region. During 2012-2019, annual hospitalization rates decreased in each region, with decreases ranging from 15.3% in the East South Central region to 48.8% in the Pacific region. By type of health insurance, Medicaid had the highest hospitalization rate nationally and in all but 1 geographic region.

Conclusions: HCV-related hospitalization rates decreased nationally and in each geographic region during 2012-2019; however, decreases were not uniform. Expanded access to direct-acting antiviral treatment in early-stage hepatitis C would reduce future hospitalizations related to advanced liver disease and interrupt HCV transmission.

Keywords: National Inpatient Sample; health care utilization; hepatitis C; hospitalization; regional differences.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(A) Age-adjusted HCV-related hospitalization rates and (B) estimated number of HCV-related hospitalizations, by US Census Bureau division, National Inpatient Sample, 2012-2019. US Census Bureau divisions: New England (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont), Middle Atlantic (New Jersey, New York, Pennsylvania), East North Central (Illinois, Indiana, Michigan, Ohio, Wisconsin), West North Central (Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota), South Atlantic (Delaware, District of Columbia, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia), East South Central (Alabama, Kentucky, Mississippi, Tennessee), West South Central (Arkansas, Louisiana, Oklahoma, Texas), Mountain (Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming), Pacific (Alaska, California, Hawaii, Oregon, Washington). Abbreviation: HCV, hepatitis C virus. Data sources: Agency for Healthcare Research and Quality, and US Census Bureau.
Figure 2.
Figure 2.
Estimated annual age-adjusted rates of HCV-related hospitalizations by US Census Bureau division, National Inpatient Sample, 2012-2019. Abbreviation: HCV, hepatitis C virus. Data source: Agency for Healthcare Research and Quality.,
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. QuickStats: percentage of adults aged ≥18 years with current hepatitis C virus infection, by health insurance coverage—National Health and Nutrition Examination Survey, United States, January 2017–March 2020. MMWR Morb Mortal Wkly Rep. 2022;71(32):1035. doi: 10.15585/mmwr.mm7132a4 - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention. Viral hepatitis surveillance—United States. 2024. Accessed November 13, 2022. https://www.cdc.gov/hepatitis/statistics/SurveillanceRpts.htm
    1. Thomas DL, Seeff LB. Natural history of hepatitis C. Clin Liver Dis. 2005;9(3):383-398, vi. doi: 10.1016/j.cld.2005.05.003 - DOI - PubMed
    1. Hofmeister MG, Zhong Y, Moorman AC, Samuel CR, Teshale EH, Spradling PR. Temporal trends in hepatitis C–related hospitalizations, United States, 2000-2019. Clin Infect Dis. 2023;77(12):1668-1675. doi: 10.1093/cid/ciad425 - DOI - PMC - PubMed
    1. Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable. Hepatitis C: State of Medicaid Access, 2022 National Summary Report. 2022. Accessed November 13, 2022. https://stateofhepc.org/wp-content/uploads/2022/06/State-of-Hep-C-Report...

LinkOut - more resources