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中国北京十余年来以人布鲁氏菌病为主要诊断的住院病例住院时间和费用的影响因素。

Factors influencing length of stay and costs in inpatient cases of human brucellosis as the primary diagnosis over a decade in Beijing, China.

机构信息

Executive Office, Medical Service Department of PLA General Hospital, Beijing, China.

Hospital Management Institute, Department of Innovative Medical Research, Chinese PLA General Hospital, Beijing, China.

出版信息

Front Public Health. 2024 May 15;12:1347693. doi: 10.3389/fpubh.2024.1347693. eCollection 2024.

Abstract

AIMS

In the year 2021, human brucellosis ranked fifth in terms of the number of cases among all statutorily notifiable infectious diseases in China, thus remaining a significant concern for public health. This study aims to provide insights into the financial burden of human brucellosis by examining hospital stays and associated costs for affected individuals.

METHODS

In this retrospective study, we gathered updated data from 467 inpatient cases primarily diagnosed with human brucellosis at eight major tertiary hospitals in Beijing, China, spanning from 2013 to 2023. To comprehensively explore the economic impact on individuals, we not only analyzed the duration of hospital stays and total costs but also examined various charge types, including drug, lab test, medical imaging, medical treatment, surgical procedures, medical supplies and consumables, inpatient bed care, nursing services, and other services costs. Statistical analysis was employed to compare differences among gender, age, ethnicity, type of health insurance, condition at admission, comorbidity index, the performance of surgery, and the site of infection.

RESULTS

Both the length of stay and total cost exhibited significant variations among insurance, surgery, and infection site groups. Utilization categories demonstrated significant differences between patients who underwent surgery and those who did not, as well as across different infection sites. Furthermore, multiple linear regression analysis revealed that the condition at admission, Elixhauser comorbidity index, infection site, and surgery influenced both hospital stay and total cost. In addition, age and insurance type were associated with total costs.

CONCLUSION

By delving into various utilization categories, we have addressed a significant gap in the literature. Our findings provide valuable insights for optimizing the allocation and management of health resources based on the influencing factors identified in this study.

摘要

目的

2021 年,布鲁氏菌病在中国法定报告传染病中病例数排名第五,仍然是重大的公共卫生关切。本研究旨在通过调查患者住院时间和相关费用,了解人类布鲁氏菌病的经济负担。

方法

本回顾性研究收集了中国北京 8 家大型三级医院 2013 年至 2023 年期间主要诊断为人类布鲁氏菌病的 467 例住院患者的最新数据。为全面评估个人经济影响,我们不仅分析了住院时间和总费用,还考察了各种费用类型,包括药物、实验室检查、医学影像、医疗、手术、医疗用品和耗材、住院床位护理、护理服务和其他服务费用。采用统计学方法比较了不同性别、年龄、民族、医疗保险类型、入院时病情、合并症指数、手术情况和感染部位之间的差异。

结果

保险、手术和感染部位组别之间的住院时间和总费用均存在显著差异。手术组和非手术组以及不同感染部位之间的利用类别存在显著差异。此外,多元线性回归分析表明,入院时病情、Elixhauser 合并症指数、感染部位和手术均影响住院时间和总费用。年龄和医疗保险类型与总费用有关。

结论

通过深入研究各种利用类别,我们填补了文献中的一个重要空白。本研究结果为基于所确定的影响因素优化卫生资源的分配和管理提供了有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab18/11135170/5538862499c1/fpubh-12-1347693-g001.jpg

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