Hospitalization Spending for Inpatients Affected by Sleep Disorders: Results from Hunan, China

Abstract

Background Sleep disorders are conditions that result in alters in normal sleeping. There are many sleep disorders and the most frequently discussed major sleep disorders include insomnia, in which the patients have difficulty falling asleep or staying asleep throughout the night; sleep apnea, in which the patients experience abnormal patterns in breathing while sleeping; and narcolepsy, a condition characterized by extreme sleepiness during the day and falling asleep suddenly during the day.Methods Population health data were extracted from Chinese National Health Statistics Network Reporting System (CNHSNRS) for the province of Hunan in China. Patients affected by sleep disorders (ICD-10 codes F51.0 and G47.0) as the principal diagnosis and hospitalized between 1 January 2017 and 31 December 2019 were included. Information on age, gender, number of comorbidities, type of sleep disorders, level of hospital, location of hospital, hospital costs, length of stay, admission year, and method of payment were retrieved from CNHSNRS. Median with interquartile range (IQR) was used to describe the hospital costs and Kruskal-Wallis test was conducted to examine significant differences among different groups. Quantile regression was applied to investigate how the hospital costs at low and high quantile of the distribution vary across groups.Results Hospital costs for patients suffering from sleep disorders were substantial: $1229.31 per patient, nearly a quarter and almost all per capita disposable yearly household income of urban ($5,024.30) and rural ($1,914.53) residents in Hunan in 2017, respectively. The study also identified several significant independent variables associated with hospital costs, including age, gender, type of sleep disorder, and hospital characteristics. In-hospital care for sleep apnea accounted for almost 80% of the total spending, and about half of the spending was from the patient’s pocket money.Conclusion Hospital costs for patients suffering from sleep disorders were substantial: nearly a quarter and almost all per capita disposable yearly household income of urban and rural residents in Hunan in 2017, respectively. Age, gender, type of sleep disorder, and hospital characteristics were significant independent variables associated with hospital costs.