Wang Wen-Yuan, Zhang Tao, Li Wan-Yi, Wang Shu-Ying, Zhao Qi-Jun, Wang Yong-Jun
Pediatric Respiratory Department II, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China.
Front Public Health. 2025 Mar 28;13:1546542. doi: 10.3389/fpubh.2025.1546542. eCollection 2025.
Tracheobronchial foreign body aspiration (TFBA) constitutes a life-threatening pediatric emergency with substantial clinical and public health implications. While current research prioritizes diagnostic and therapeutic strategies for TFBA, limited attention has been paid to its socioeconomic consequences. This study focuses on Gansu Province, a representative underdeveloped region in China, to systematically assess both direct medical costs (surgical interventions and hospitalization) and broader socioeconomic impacts of pediatric TFBA management. The findings aim to inform evidence-based healthcare policies for childhood emergencies in resource-limited settings.
Using Gansu Provincial statistical data, we analyzed the economic burden of 951 pediatric tracheobronchial foreign body cases (2017-2021) meeting inclusion criteria at a provincial tertiary hospital's respiratory department.
(1) Urban-rural disparities in economic burden: The average annual total income of rural households was significantly lower than that of urban households ( < 0.01). The proportion of hospitalization costs relative to income in rural areas reached 36.31 ± 4.43%, 3.1 times that of urban households (11.91 ± 2.14%, < 0.001). Rural minority-concentrated regions bore the heaviest burden (48.06%), while urban Han-majority regions had the lowest burden (9.29%). No significant urban-rural difference in surgical costs (>0.05). (2) Regional heterogeneity in economic burden: Hospitalization costs in underdeveloped minority-concentrated rural areas reached 13,323¥ (8% higher than the rural average), yet their income (27,678¥) was 33% below the average. Their cost-to-income ratio (48.06%) was 3.2 times that of their urban counterparts (15.21%). In developed Han-majority regions, despite comparable hospitalization costs (11,872 ¥ vs. 12,339 ¥), the higher income (42% above average) resulted in the lowest cost-to-income ratio (21.52%).
TFBA poses a critical global health challenge with disproportionate impacts on children aged 1-3 years and significant economic burden on families, especially in underdeveloped minority-concentrated rural areas. This study highlights severe urban-rural disparities in economic burdens.
气管支气管异物吸入（TFBA）是一种危及生命的儿科急症，具有重大的临床和公共卫生影响。虽然目前的研究优先关注TFBA的诊断和治疗策略，但对其社会经济后果的关注有限。本研究聚焦于中国一个具有代表性的欠发达地区甘肃省，系统评估儿科TFBA管理的直接医疗费用（手术干预和住院）以及更广泛的社会经济影响。研究结果旨在为资源有限环境下儿童急症的循证医疗政策提供依据。
利用甘肃省统计数据，我们分析了一家省级三级医院呼吸科951例符合纳入标准的儿科气管支气管异物病例（2017 - 2021年）的经济负担。
（1）经济负担的城乡差异：农村家庭年均总收入显著低于城市家庭（<0.01）。农村地区住院费用占收入的比例达到36.31±4.43%，是城市家庭的3.1倍（11.91±2.14%，<0.001）。农村少数民族聚居地区负担最重（48.06%），而城市汉族聚居地区负担最轻（9.29%）。手术费用城乡无显著差异（>0.05）。（2）经济负担的区域异质性：欠发达少数民族聚居农村地区的住院费用达到13,323元（比农村平均水平高8%），但其收入（27,678元）比平均水平低33%。其成本收入比（48.06%）是城市地区的3.2倍（15.21%）。在发达的汉族聚居地区，尽管住院费用相当（11,872元对12,339元），但较高的收入（比平均水平高42%）导致成本收入比最低（21.52%）。
TFBA对全球卫生构成重大挑战，对1 - 3岁儿童影响不均衡，给家庭带来巨大经济负担，尤其是在欠发达少数民族聚居农村地区。本研究突出了经济负担方面严重的城乡差异。
