Institute of Health Studies, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Yuhua Street, Chenggong District, Kunming, Yunnan, 650500, China.
Department of Pulmonary and Critical Care Medicine, the First People's Hospital of Yunnan Province, 157 Jinbi Road, Xishan District, Kunming, Yunnan, 650032, China.
BMC Health Serv Res. 2024 Nov 28;24(1):1496. doi: 10.1186/s12913-024-11874-4.
To understand the hospitalization expenditures and the composition of hospitalized patients with chronic obstructive pulmonary disease (COPD) in Yunnan Province from 2016 to 2022 and to identify the factors that influence them. The study aims to provide evidence-based information to health administration, hospitals, health insurance offices, and other related departments to help them formulate relevant policies.
This study analyzed data from 728,980 COPD patients in Yunnan Province between 2016 and 2022. This study described trends in hospitalization expenditures and their components over a 7-year period. Path analysis was used to investigate the factors that affect hospitalization expenditures.
The average hospitalization expenditures for 2016-2022 were 7828 CNY. The total hospitalization expenditures were continuously increasing, from 828 million CNY to 967 million CNY, which is a 16.84% increase. However, the average expenditure per hospitalization decreased from 9185 CNY to 7261 CNY, which is a decrease of 20.95%. The main components of hospitalization expenditures were diagnostic fees, medication fees, and comprehensive medical service fees. The proportion of medication fees is decreasing, while the proportion of diagnostic fees and comprehensive medical services fees are increasing. The results of the path analysis indicate that age, gender, ethnicity, hospital level, admission route, medical payment method, COPD with acute lower respiratory tract infection, non-acute exacerbation of COPD, rehabilitation treatment experience, and comorbidity have both direct and indirect effects on hospitalization expenditures through length of stay (LOS). Additionally, marital status indirectly affects hospitalization expenditures through LOS.
Shortening the average LOS is crucial for hospitals to improve efficiency and reduce unnecessary expenses for patients. To achieve this, it is necessary to actively implement clinical pathway management and establish a standardized diagnosis and treatment system.
了解云南省慢性阻塞性肺疾病（COPD）患者住院费用及构成，分析其影响因素，为卫生行政部门、医院、医保经办机构等相关部门制定政策提供依据。
本研究分析了云南省 2016 年至 2022 年 728980 例 COPD 患者住院费用数据，描述了 7 年住院费用及构成的变化趋势，采用路径分析方法探讨影响住院费用的因素。
2016-2022 年云南省 COPD 患者平均住院费用为 7828 元，总住院费用呈持续增长趋势，由 8.28 亿元增加至 9.67 亿元，增长 16.84%；但次均住院费用由 9185 元降至 7261 元，下降 20.95%。住院费用主要构成为检查费、药品费和治疗费，其中药品费占比逐渐下降，检查费和治疗费占比逐渐上升。路径分析结果显示，年龄、性别、民族、医院级别、入院途径、支付方式、合并 COPD 急性下呼吸道感染、非急性加重期 COPD、康复治疗经历、合并症等因素通过住院天数（LOS）对住院费用产生直接和间接影响，婚姻状况通过 LOS 对住院费用产生间接影响。
缩短平均 LOS 对医院提高效率、减少患者不必要费用支出具有重要意义，应积极推行临床路径管理，建立规范的诊疗体系。
