Evaluation of admission characteristics, hospital length of stay and costs for cerebral infarction in a medium‐sized city in China

Ma, Yu; Liu, Y.; Fu, Hanhui; Wang, X. M.; Wu, Bihua; Wang, Shuqi; Peng, Guo-Guang

doi:10.1111/j.1468-1331.2010.03007.x

Cited by 40 publications

(45 citation statements)

References 35 publications

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“…The findings of the multiple linear regression analysis were unlike much previous research [18, 19] in that people with the new cooperative medical scheme had a longer LOS than people with Urban Resident Basic Medical Insurance and with Urban Employee Basic Medical Insurance. Despite a relatively high coverage of medical insurance in China, the coverage provided by different types of social medical insurance in the country varies greatly.…”

Section: Discussioncontrasting

confidence: 99%

Assessment of hospital length of stay and direct costs of type 2 diabetes in Hubei Province, China

Chen

Shuai

Tan

et al. 2017

BMC Health Serv Res

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BackgroundThe incidence of type 2 diabetes is increasing, creating a huge burden for China’s social healthcare system. This study aimed to evaluate hospital length of stay (LOS) based on admission characteristics and direct costs correlated with various types of complications for type 2 diabetic inpatients in Hubei Province, China.MethodsA total of 1528 inpatients diagnosed with type 2 diabetes discharged between April 1, 2013, and March 31, 2014, were included in this study. Information regarding patients’ admission and hospitalization were obtained from the hospital information system. The relationship between admission characteristics and LOS, distribution of total costs, and types of complications were described and analysed.Results(1) The mean LOS was 11.65 days (median: 10 days). Multiple linear regression analysis demonstrated that inpatients with New Cooperative Medical Scheme (NCMS), aged 80 and above, had longer LOS than the reference group, and inpatients with chronic or acute + chronic complications had shorter LOS than those without. (2) Mean total costs per patient were US$159.72 ± 130.83 (median: US$135.33), US$240.60 ± 166.58 (median: US$192.09), and US$247.98 ± 166.22 (median: US$200.99) for inpatients with no complications, chronic complications, and acute + chronic complications, respectively. Total and individual costs were significantly less for patients without complications than for those with the two types of complications (p < 0.001). (3) Mean total costs per patient were US$225.40 ± 115.32 (median: US$200.34), US$221.25 ± 177.64 (median: US$170.05), and US$275.18 ± 193.14 (median: US$217.91) for inpatients with microvascular complications, macrovascular complications, and microvascular + macrovascular complications, respectively. Total costs were significantly higher for patients with microvascular + macrovascular complications than for those with other types of chronic complications (p < 0.001). (4) Drugs were the greatest expense for patients, and the least expensive treatment was nursing care.ConclusionsMedical insurance status, age, and type of complication may help to predict LOS for patients with type 2 diabetes in Hubei Province, China. The total and individual costs for patients with complications were higher than for those without, and hospitalization expenses posed a heavy burden. Efforts should be made to reduce the financial impact on patients by integrating the medical insurance system of urban and rural areas, and by reducing the risk of complications, especially microvascular complications.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2140-4) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 99%

Assessment of hospital length of stay and direct costs of type 2 diabetes in Hubei Province, China

Chen

Shuai

Tan

et al. 2017

BMC Health Serv Res

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“…While it is difficult to directly compare this study with previous studies due to the use of different categories of charge (or cost) data,3,7,12,18,21 comparison was made possible by reorganizing the charges of similar items. In particular, three categories - pharmaceutical care, laboratory tests, and imaging studies - were comparable.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies found that the total cost of hospitalization due to stroke was significantly associated with the length of stay (LOS), stroke severity, clinical subtype, and certain sociodemographic factors,3,6-10 of which LOS was found to be the most decisive factor in determining the total cost of hospitalization of stroke patients 3,7,11. This has led to suggestions that shortening the LOS would be an effective and critical strategy for managing healthcare costs 12,13…”

Section: Introductionmentioning

confidence: 99%

Itemized Hospital Charges for Acute Cerebral Infarction Patients Influenced by Severity in an Academic Medical Center in Korea

2012

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Background and PurposeStroke imposes a major burden on patients, their families, and the national healthcare system. The purpose of this study was to determine the itemized hospital charges in acute ischemic stroke patients according to their severity by partitioning the charges in detail and then examining whether stroke severity was a significant contributor to these charges.MethodsThis study analyzed data of first-time acute ischemic stroke patients who had been admitted to an academic medical center between September 2003 and April 2009. The patients' demographic and clinical characteristics were analyzed descriptively, and then eight categorized hospital charges as well as the total charge were compared among patients grouped according to stroke severity, using analysis of variance. Multiple regression analyses were conducted to test the influence of stroke severity on itemized hospital charges as well as the total charge, while controlling for other related factors.ResultsMore-severe strokes were associated with a higher total charge. Significantly higher charges were associated with patients with more-severe strokes regarding all charged items except imaging studies. The charges for imaging studies were similar across all severities of stroke. While controlling for other factors, a significant impact of stroke severity was found in both the total hospital charge and most itemized charges.ConclusionsItemized hospital charges for inpatients with acute ischemic stroke varied according to stroke severity. Stroke severity was a significant factor influencing the itemized charges of acute hospitalization of ischemic stroke patients.

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“…Interestingly, the cost was significantly higher for younger patients, which may indicate that physicians may offer more active treatment plans for younger patients. It has been identified that medical insurance type influences on stroke treatment costs [6,15]. Cost per stay associated with URBMI and NRCMI program was significantly higher than poverty relief and free medical service program with a difference of around 1,800 USD per stay, probably because both programs push hospitals to control cost with shorter LoS.…”

Section: Discussionmentioning

confidence: 99%

Inpatient Cost of Stroke in Beijing: A Descriptive Analysis

et al. 2018

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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.

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Evaluation of admission characteristics, hospital length of stay and costs for cerebral infarction in a medium‐sized city in China

Cited by 40 publications

References 35 publications

Assessment of hospital length of stay and direct costs of type 2 diabetes in Hubei Province, China

Assessment of hospital length of stay and direct costs of type 2 diabetes in Hubei Province, China

Itemized Hospital Charges for Acute Cerebral Infarction Patients Influenced by Severity in an Academic Medical Center in Korea

Inpatient Cost of Stroke in Beijing: A Descriptive Analysis

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