Qu Cuiyun, Liu Wei, Chen Lingling, Zhang Lei, Xue Feng, Yang Renchi
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin Key Laboratory of Gene Therapy for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases Tianjin China.
Res Pract Thromb Haemost. 2022 Jul 21;6(5):e12764. doi: 10.1002/rth2.12764. eCollection 2022 Jul.
To what extent hospital use and medical resources are used on hemophilia care in China's health care system is unknown.
This study was based on a single center in China and was conducted to comprehensively assess the resource use for hospitalization of people with hemophilia.
We analyzed clinical characteristics, diagnosis, inhibitor status, reasons, length of stay, and hospital costs of 323 hospitalizations in which hemophilia must be considered as the main factor for hospitalization from January 2009 to December 2020 at the Institute of Hematology and Blood Diseases Hospital in Tianjin, China.
There were 265 hospitalizations for people with hemophilia A (HA) and 58 with hemophilia B (HB). Seventy-eight hospitalizations (24%) were for patients with inhibitor (INH+). Minor bleeding (eg, hemarthrosis, hematuria) was the most common reason for hospitalization. The cost of clotting factor concentrates was the major burden of inpatients with hemophilia. Total cost in a single hospitalization of a person with HA (median, 21,281 Chinese yuan [¥]) was about twice that for HB (median, ¥11,060). Expenditure of drugs in HA (median ¥14,157) was two to three times more than that in HB (median, ¥5707). Total cost and drug cost in hospitalizations of people with inhibitors were about two times more than these without (INH-) (median cost in INH+ hospitalizations: total cost, ¥27,303; drug cost, ¥20,445. Median cost in INH- hospitalizations: total cost, ¥17,743; drug cost, ¥11,973.).
For hemophilia, the most dominant cost during hospitalization was on clotting factor concentrates. Diagnosed HA and inhibitor positivity increased the global cost.
在中国医疗体系中,血友病护理的医院利用情况和医疗资源使用程度尚不清楚。
本研究基于中国的一个单一中心,旨在全面评估血友病患者住院的资源使用情况。
我们分析了2009年1月至2020年12月期间在中国天津血液学研究所血液病医院因血友病必须被视为住院主要因素的323例住院病例的临床特征、诊断、抑制物状态、原因、住院时间和住院费用。
甲型血友病(HA)患者住院265例,乙型血友病(HB)患者住院58例。78例住院(24%)是针对有抑制物的患者(INH+)。轻微出血(如关节积血、血尿)是最常见的住院原因。凝血因子浓缩物的费用是血友病住院患者的主要负担。HA患者单次住院的总费用(中位数,21,281元人民币)约为HB患者的两倍(中位数,11,060元)。HA患者的药物支出(中位数14,157元)比HB患者多两到三倍(中位数,5707元)。有抑制物的患者住院的总费用和药物费用比没有抑制物的患者(INH-)高出约两倍(INH+住院的中位数费用:总费用,27,303元;药物费用,20,445元。INH-住院的中位数费用:总费用,17,743元;药物费用,11,973元)。
对于血友病,住院期间最主要的费用是凝血因子浓缩物。确诊为HA和抑制物阳性增加了总体费用。