Yu Miao, Huang Zhongmou, Yang Yansui, Wang Yulin, Ren Hai, Tang Shilan
School of Healthcare Management, Tsinghua University, Beijing, China.
School of Public Policy and Management, Tsinghua University, Beijing, China.
Front Public Health. 2025 Apr 17;13:1552162. doi: 10.3389/fpubh.2025.1552162. eCollection 2025.
This study aims to compare hospitalization costs between traumatic brain injury (TBI) and non-traumatic brain injury (non-TBI) patients with disorders of consciousness (DoC) to explore cost determinants.
A retrospective analysis was conducted on 210 DoC inpatients admitted to Shenzhen Longcheng Hospital, a tertiary rehabilitation hospital located in China's Pearl River Delta region, between 2015 and 2020. Patients were categorized into TBI ( = 44) and non-TBI ( = 166) groups based on etiology. Demographic, clinical, and hospitalization cost data were collected for each patient. The study compared the cost composition for DoC patients by etiology and used multivariate analysis to identify factors influencing hospitalization costs.
The median length of stay (LOS) and cost for TBI patients were 363.5 days and $57,366.05, respectively, while for non-TBI patients, the medians were 280.5 days and $57,117.64. Across both groups, the highest cost components were rehabilitation, medication, and treatment expenses. Factors associated with higher hospitalization costs included non-TBI etiology, local residents, medical insurance, LOS, self-employed, surgical treatment, and traditional Chinese medicine (TCM) intervention.
Hospitalization cost structures were similar across etiologies, emphasizing value-driven care priorities. Key factors associated with higher hospitalization costs included non-TBI etiology, local residency, medical insurance, LOS, self-employment status, surgery, and TCM. These findings highlight key drivers of healthcare costs in DoC care, emphasizing the need for targeted policy interventions. However, given the limitations of this study, further research with larger, more diverse samples is essential to comprehensively assess the impact of costs on patient outcomes and care quality.
本研究旨在比较创伤性脑损伤（TBI）和非创伤性脑损伤（非TBI）导致意识障碍（DoC）患者的住院费用，以探索成本决定因素。
对2015年至2020年期间在中国珠江三角洲地区的一家三级康复医院——深圳龙城医院收治的210例DoC住院患者进行回顾性分析。根据病因将患者分为TBI组（n = 44）和非TBI组（n = 166）。收集每位患者的人口统计学、临床和住院费用数据。该研究比较了不同病因的DoC患者的费用构成，并使用多变量分析来确定影响住院费用的因素。
TBI患者的中位住院时间（LOS）和费用分别为363.5天和57,366.05美元，而非TBI患者的中位数分别为280.5天和57,117.64美元。在两组中，最高的费用组成部分是康复、药物和治疗费用。与较高住院费用相关的因素包括非TBI病因、当地居民、医疗保险、LOS、个体经营、手术治疗和中医（TCM）干预。
不同病因的住院费用结构相似，强调了以价值为导向的护理重点。与较高住院费用相关的关键因素包括非TBI病因、当地居住情况、医疗保险、LOS、个体经营状况、手术和中医。这些发现突出了DoC护理中医疗费用的关键驱动因素，强调了有针对性的政策干预的必要性。然而，鉴于本研究的局限性，使用更大、更多样化的样本进行进一步研究对于全面评估费用对患者结局和护理质量的影响至关重要。
