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COPD 病例的住院费用及其相关因素:中国河南省两家大型公立三级医院的观察性研究。

Hospitalization costs of COPD cases and its associated factors: an observational study at two large public tertiary hospitals in Henan Province, China.

机构信息

Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.

School of Journalism and Communication, Wuhan University, Wuhan, 430072, Hubei, China.

出版信息

BMC Geriatr. 2023 Jul 25;23(1):457. doi: 10.1186/s12877-023-04087-7.

Abstract

BACKGROUND

The increasing prevalence of Chronic Obstructive Pulmonary Disease (COPD) has imposed a considerable economic burden. However, there remains a paucity of relevant evidence regarding the hospitalization costs of COPD cases. Therefore, in this study, we aimed to assess the hospitalization costs among COPD cases and investigate the factors that contribute to their costs in Henan Province, China.

METHODS

We enrolled a total of 1697 cases who were discharged with a diagnosis of COPD from January 1, 2020 to December 31, 2020, into the study. Demographic and clinical characteristics of the cases were obtained from the hospital information system (HIS) of two large tertiary hospitals in Henan Province, China. The factors associated with hospitalization costs were examined using a multiple linear regression model.

RESULTS

Total hospitalization costs of 1697 COPD cases were $5,419,011, and the median was $1952 (IQR:2031). Out-of-pocket fees accounted for 43.95% of the total hospitalization costs, and the median was $938 (IQR:956). Multiple linear regression analysis revealed that hospitalization costs were higher among older cases, cases with more comorbidities, and cases with longer length of stay. Furthermore, hospitalization costs were higher in cases who paid through private expenses compared to those covered by Urban Employee Basic Medical Insurance. Additionally, we found that cases admitted through an outpatient clinic had higher hospitalization costs than those admitted through the emergency department.

CONCLUSION

Hospitalization costs of COPD cases are substantial. Strategies to reduce hospitalization costs, such as shortening LOS, optimizing payment plans, and preventing or managing complications, should be implemented to alleviate the economic burden associated with COPD hospitalizations.

摘要

背景

慢性阻塞性肺疾病(COPD)的患病率不断上升,给经济带来了巨大的负担。然而,关于 COPD 患者的住院费用,相关证据仍然较少。因此,本研究旨在评估中国河南省 COPD 患者的住院费用,并探讨导致其费用的因素。

方法

我们共纳入了 2020 年 1 月 1 日至 12 月 31 日期间,从两家大型三级医院出院诊断为 COPD 的 1697 例患者。患者的人口统计学和临床特征从医院信息系统(HIS)中获取。采用多元线性回归模型分析与住院费用相关的因素。

结果

1697 例 COPD 患者的总住院费用为 541.9011 美元,中位数为 1952 美元(IQR:2031)。自付费用占总住院费用的 43.95%,中位数为 938 美元(IQR:956)。多元线性回归分析显示,年龄较大、合并症较多和住院时间较长的患者住院费用较高。此外,自费患者的住院费用高于城镇职工基本医疗保险患者。另外,我们发现,从门诊就诊的患者比从急诊就诊的患者的住院费用更高。

结论

COPD 患者的住院费用较高。应采取缩短住院时间、优化支付计划、预防或治疗并发症等策略来降低住院费用,以减轻 COPD 住院治疗的经济负担。

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