Department of Neurology, Peking University First Hospital, Beijing, China.
Department of Neurology, Second Hospital of Hebei Medical University, Shijiazhuang, China.
Front Public Health. 2021 Dec 10;9:783242. doi: 10.3389/fpubh.2021.783242. eCollection 2021.
Studies on the regional differences in hospital costs of acute ischemic stroke (AIS) are scarce in China. We aimed to explore the regional differences in hospital costs and identify the determinants of hospital costs in each region. Data were collected from the Chinese Acute Ischemic Stroke Treatment Outcome Registry (CASTOR), a multicenter prospective study on patients diagnosed with AIS and hospitalized from 2015 to 2017. Univariate and multivariate analyses were undertaken to identify the determinants of hospital costs of AIS. A total of 8,547 patients were included in the study, of whom 3,700 were from the eastern area, 2,534 were from the northeastern area, 1,819 were from the central area, and 494 were from the western area. The median hospital costs presented a significant difference among each region, which were 2175.9, 2175.1, 2477.7, and 2282.4 dollars in each area, respectively. Each region showed a similar hospital cost proportion size order of cost components, which was Western medicine costs, other costs, diagnostic costs, and traditional medicine costs, in descending order. Male sex, diabetes mellitus, severe stroke symptoms, longer length of stay, admission to the intensive care unit, in-hospital complications of hemorrhage, and thrombectomy were independently associated with hospital costs in most regions. Hospital costs in different regions showed a similar proportion size order of components in China. Each region had different determinants of hospital costs, which reflected its current medical conditions and provided potential determinants for increasing medical efficiency according to each region's situation.
在中国,关于急性缺血性脑卒中(AIS)医院费用的区域差异研究较少。本研究旨在探讨医院费用的区域差异,并确定各地区医院费用的决定因素。
数据来自中国急性缺血性脑卒中治疗结局登记研究(CASTOR),该研究是一项多中心前瞻性研究,纳入了 2015 年至 2017 年期间诊断为 AIS 并住院的患者。采用单因素和多因素分析来确定 AIS 医院费用的决定因素。
本研究共纳入 8547 例患者,其中东部地区 3700 例,东北地区 2534 例,中部地区 1819 例,西部地区 494 例。各地区的中位医院费用存在显著差异,分别为 2175.9、2175.1、2477.7 和 2282.4 美元。各地区的费用构成比例大小顺序相似,均为西药费、其他费用、诊断费和中药费。男性、糖尿病、严重的脑卒中症状、住院时间较长、入住重症监护病房、院内出血并发症和取栓术与大多数地区的医院费用独立相关。
不同地区的医院费用在各地区的构成比例大小顺序相似,但医院费用的决定因素不同,这反映了各地区当前的医疗状况,并为根据各地区的情况提高医疗效率提供了潜在的决定因素。