Inpatient Cost of Stroke in Beijing: A Descriptive Analysis

Abstract

Background: Stroke has been the leading cause of death in China and contributed almost one-third to stroke deaths worldwide. The rising cost of stroke treatment is of great concern, but has not been thoroughly studied. This study aimed to analyze stroke in-hospital charges by subtypes, age, and sex and investigate potential factors associated with the cost of per stay. Methods: The research was a retrospective observational study based on patients with a primary diagnosis of stroke from 31 hospitals in Beijing. Characteristics of total treatment cost and cost of per stay were analyzed. The potential influences on hospital charges were explored using a stepwise multiple regression model. Results: A total of 16,111 stroke in-patient admissions were identified among which 8.3% was subarachnoid hemorrhage, 22.4% intracerebral hemorrhage, and 69.1% cerebral infarction. The average length of stay (LoS) was 14.5 (11.9) days. The cost of per stay was USD 4,423.9 (6,684.4) among which the out-of-pocket expenses were USD 1,640.2 (3,118.0). Stroke type, age, medical insurance, treatment results, and hospital level were significantly associated with the cost of stroke (p < 0.001). Conclusion: Hospitalization cost of stroke was substantial. These findings provide health policymakers and healthcare professionals with evidence to help guide future spending.

Hospitalization costs among immobile patients with hemorrhagic or ischemic stroke in China: a multicenter cross-sectional study

“…Also, the composition of hospitalization costs is parallel in IHS or IIS. Compared with other studies carried out in China, the cost composition is mostly consistent with those in previous studies whereas the proportion of medicine fees is lower [ 7 , 10 , 11 ]. This may be attributable to the large reform to China’s health system implemented in public hospitals during the past decade, which imposed zero markup on drug costs and encouraged the use of inexpensive medications [ 20 , 21 ].…”

“…It is plausible that IHS tend to require more complex medical treatment or nursing interventions than IIS; thus, the median materials fees, medical service fees, and total costs for patients with severe illness may be higher in IHS. This is in line with the results of other resource-use studies indicating higher costs in patients with hemorrhagic stroke than in those who have ischemic stroke [10,11]. Therefore, it is necessary to increase the reimbursement ratio of medical insurance for patients with hemorrhagic stroke, to reduce the personal medical expenses of these patients.…”

“…The average LoS for all immobile patients with stroke was 15.45 ± 11.89 days in this study, which is longer than in previous reports from China [10,11] and Europe [18,22]. In most countries, patients with stroke are hospitalized for a short period of 10 to 15 days [5].…”

“…Although many medical care resources have been invested in stroke management [4], the costs for the main stroke subtypes vary owing to different potentially associated factors. Understanding the cost composition and the differences in stroke subtypes can help policymakers discern which types of cost and which contributors are driving increases in spending [10].…”

“…Previous studies have reported the economic burden of stroke treatment and care, but the results were limited to only one subtype of stroke [ 11 , 12 ]. Retrospective observational studies have also been conducted, based on the Beijing Public Health Information Center database; however, this database only includes cost data from one region and therefore lacks representativeness [ 10 – 12 ]. Another study used cost data based on a single-center database, with a comparatively limited sample size [ 7 ].…”