Path Analysis of Hospitalization Expenses of 2,164 Appendicitis Patients at County-Level Public Hospitals in Anhui Province, China

Abstract

Background and objectiveAppendicitis resection is one of the most common surgical procedures in China. Hospitalization expenses are a major determinant of appendicitis treatment. This study explored the factors influencing hospitalization expenses of appendicitis surgery patients in Anhui province and provided a scientific basis for reasonably controlling medical expenses.MethodsA multi-stage random cluster sampling method was used to collect case information on 2,164 patients who underwent appendicitis surgery at 6 county-level public hospitals in Anhui province, China. Path analysis was used to study the factors influencing hospitalization expenses of appendicitis surgery patients.ResultsThe average length of stay (LOS) was 5.62 ± 2.64 days, with a median of 5 days; the average hospitalization expenses were 6,109.60 ± 2,109.44 CNY, with a median of 5,511.93 CNY. The direct effect of LOS was 0.535, which was the most important direct factor affecting hospitalization expenses, and the remaining path coefficient was 0.699. surgical grades, surgical methods, and chronic appendicitis directly affected hospitalization expenses, with direct effects of 0.149, 0.081, and -0.037; surgical costs, anesthesia costs, disease outcomes, age, acute simple appendicitis, and operative duration (OD) not only directly affected hospitalization expenses, but also indirectly affected hospitalization expenses through the LOS, and the total effects were 0.283, 0.045, 0.200, 0.202, -0.162, and 0.062, respectively. The total number of surgeons and assistants only indirectly affected the hospitalization expenses through the LOS, and the indirect effect was 0.020.ConclusionsThe LOS is the most important factor affecting hospitalization expenses. Controlling hospitalization expenses is an effective method of reducing the economic burden of patients undergoing appendicitis surgery and decreasing hospital medical expenditures. Based on controlling the average LOS, combined with other comprehensive measures such as decreasing the OD and health education, strengthening controllable factors, and effectively managing the unreasonable increase in hospitalization expenses.

Hospitalization Costs for Patients with Acute Appendicitis: An Update Using Real-World Data from a Large Province in China

“…Comorbidities of the patient are another element that influences the cost, and the elderly generally have more comorbidities. 22 The main factors affecting hospitalization costs of appendicitis in the existing domestic literature were the length of stay(LOS), [23][24][25] received surgery or not, 23,25 having any comorbidities or not, 24 age, [24][25][26] appendicitis severity, 26 surgical grades 27 and payment methods. 24 Despite the abundance of literature on the subject, the majority of studies have relied on cross-sectional data with limited sample sizes from a single or a few hospitals.…”