Arroyo-Borrell Elena, Renart-Vicens Gemma, Saez Marc, Carreras Marc
Health Policy Research Unit (SEPPS), Consortium of Health and Social of Catalonia, 08022 Barcelona, Spain.
Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Carrer de la Universitat de Girona 10, Campus Montilivi, 17003 Girona, Spain.
Int J Environ Res Public Health. 2017 Sep 14;14(9):1062. doi: 10.3390/ijerph14091062.
Although patient mobility has increased over the world, in Europe there is a lack of empirical studies. The aim of the study was to compare foreign non-resident patients versus domestic patients for the particular Catalan case, focusing on patient characteristics, hospitalisation costs and differences in costs depending on the typology of the hospital they are treated. We used data from the 2012 Minimum Basic Data Set-Acute Care hospitals (CMBD-HA) in Catalonia. We matched two case-control groups: first, foreign non-resident patients versus domestic patients and, second, foreign non-resident patients treated by Regional Public Hospitals versus other type of hospitals. Hospitalisation costs were modelled using a GLM Gamma with a log-link. Our results show that foreign non-resident patients were significantly less costly than domestic patients (12% cheaper). Our findings also suggested differences in the characteristics of foreign non-resident patients using Regional Public Hospitals or other kinds of hospitals although we did not observe significant differences in the healthcare costs. Nevertheless, women, 15-24 and 35-44 years old patients and the days of stay were less costly in Regional Public Hospitals. In general, acute hospitalizations of foreign non-resident patients while they are on holiday cost substantially less than domestic patients. The typology of hospital is not found to be a relevant factor influencing costs.
尽管全球范围内患者的流动性有所增加，但在欧洲，实证研究却较为匮乏。本研究的目的是针对加泰罗尼亚的具体情况，比较外国非居民患者与本国患者，重点关注患者特征、住院费用以及根据所就诊医院类型而产生的费用差异。我们使用了来自加泰罗尼亚2012年急性护理医院最低基本数据集（CMBD - HA）的数据。我们匹配了两个病例对照组：第一，外国非居民患者与本国患者；第二，由地区公立医院治疗的外国非居民患者与其他类型医院治疗的外国非居民患者。住院费用使用具有对数链接的广义线性模型伽马分布进行建模。我们的结果表明，外国非居民患者的费用明显低于本国患者（便宜12%）。我们的研究结果还表明，使用地区公立医院或其他类型医院的外国非居民患者在特征上存在差异，尽管我们没有观察到医疗费用上的显著差异。然而，在地区公立医院，女性、15 - 24岁和35 - 44岁的患者以及住院天数的费用较低。总体而言，外国非居民患者度假期间的急性住院费用远低于本国患者。未发现医院类型是影响费用的相关因素。
