Chronic liver disease affects 3.9 million Americans, or 1.6 percent of the United States population. The most common causes are viral hepatitis, alcohol abuse, and non-alcoholic fatty liver disease, a condition that is on the rise due to our nation’s obesity epidemic. Although treatments for these conditions, including liver transplantation for patients with advanced disease, continue to improve, chronic liver disease remains the number one cause of liver cancer and 12th leading cause of death in the United States. Recent studies of patients with liver disease suggest that the quality of care, which spans from early prevention of liver-related disorders to end-of-life care, can better be optimized, and the research performed by members of our team aims to address many of these concerns.
Our liver disease health services researchers seek to identify and fix gaps in the care of patients with liver disease as it pertains to access, quality, and cost. Our own areas of research have covered a wide range of health services topics, including access to healthcare and preventive services, quality of care, racial and ethnic disparities, patient-reported outcomes, and cost-effectiveness. Dr. Folasade A. May’s previous work has focused on the economic burden of alcoholic hepatitis and on racial and ethnic disparities in health service utilization and mortality among patients with alcoholic hepatitis. Dr. Yvonne Flores has investigated the incidence and impact of early preventive practices such as detection of hepatitis C, weight loss, and education, on liver disease in Latino communities in the Unites States and Mexico. Drs. Anne M. Walling and Arpan Patel have studied the healthcare utilization and quality of end-of-life care for patients with morbid end-stage liver disease, particularly those who are not candidates for liver transplantation.
Ongoing health services projects in chronic liver disease include studies on racial and ethnic disparities in hepatitis C treatment outcomes, advance care planning in patients with end-stage liver disease, and a large observational study of the processes of care involved in healthcare access and liver cancer screening of patients with chronic liver disease across University of California medical facilities.