Factors contributing to hospitalization costs for patients with COPD in China: a retrospective analysis of medical record data

Meng Li,1 Fengyan Wang,2 Rongchang Chen,2 Zhenyu Liang,2 Yumin Zhou,2 Yuqiong Yang,2 Shengqi Chen,1 Carolina Oi Lam Ung,1 Hao Hu1 1State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao; 2State Key Laboratory of Respiratory Di...

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Main Authors: Li M, Wang FY, Chen R, Liang Z, Zhou Y, Yang Y, Chen S, Ung COL, Hu H
Format: Article
Language:English
Published: Dove Medical Press 2018-10-01
Series:International Journal of COPD
Subjects:
Online Access:https://www.dovepress.com/factors-contributing-to-hospitalization-costs-for-patients-with-copd-i-peer-reviewed-article-COPD
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author Li M
Wang FY
Chen R
Liang Z
Zhou Y
Yang Y
Chen S
Ung COL
Hu H
author_facet Li M
Wang FY
Chen R
Liang Z
Zhou Y
Yang Y
Chen S
Ung COL
Hu H
author_sort Li M
collection DOAJ
description Meng Li,1 Fengyan Wang,2 Rongchang Chen,2 Zhenyu Liang,2 Yumin Zhou,2 Yuqiong Yang,2 Shengqi Chen,1 Carolina Oi Lam Ung,1 Hao Hu1 1State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao; 2State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou China Purpose: Hospitalization brings considerable economic pressure on COPD patients in China. A clear understanding of hospitalization costs for patients with COPD is warranted to improve treatment strategies and to control costs. Currently, investigation on factors contributing to hospitalization costs for patients with COPD in China is limited. This study aimed to measure the hospitalization costs of COPD and to determine the contributing factors. Patients and methods: Medical record data from the First Affiliated Hospital of Guangzhou Medical University from January 2016 to December 2016 were used for a retrospective analysis. Patients who were hospitalized with a diagnosis of COPD were included. Patient characteristics, medical treatment, and hospitalization costs were analyzed by descriptive statistics and multivariable regression. Results: Among the 1,943 patients included in this study, 87.85% patients were male; the mean (SD) age was 71.15 (9.79) years; 94.49% patients had comorbidities; and 82.30% patients had health insurance. Regarding medical treatment, the mean (SD) length of stay was 9.38 (7.65) days; 11.12% patients underwent surgery; 87.91% used antibiotics; and 4.53% underwent emergency treatment. For hospitalization costs, the mean (SD) of the total costs per COPD patient per admission was 24,372.75 (44,173.87) CNY (3,669.33 [6,650.38] USD), in which Western medicine fee was the biggest contributor (45.53%) followed by diagnosis fee (27.00%) and comprehensive medical fee (12.04%). Regression found that reimbursement (-0.032; 95% CI -0.046 to 0.007), length of stay (0.738; 95% CI 0.832–0.892), comorbidity (0.044; 95% CI 0.029–0.093), surgery (0.145; 95% CI 0.120–0.170), antibiotic use (0.086; 95% CI 0.060–0.107), and emergency treatment (0.121; 95% CI 0.147–0.219) were significantly (P<0.01) associated with total hospitalization costs. Conclusion: To control hospitalization costs for COPD patients in China, the significance of comorbidity, length of stay, antibiotic use, surgery, and emergency treatment suggests the importance of controlling the COPD progression and following clinical guidelines for inpatients. Interventions such as examination of pulmonary function for early detection, quality control of medical treatment, and patient education warrant further investigation. Keywords: COPD, economic burden, hospitalization costs, medical cost, multivariate regression
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spelling doaj.art-7c513fd67c284b0b8a30db5f50e1a3902022-12-21T19:06:01ZengDove Medical PressInternational Journal of COPD1178-20052018-10-01Volume 133349335741426Factors contributing to hospitalization costs for patients with COPD in China: a retrospective analysis of medical record dataLi MWang FYChen RLiang ZZhou YYang YChen SUng COLHu HMeng Li,1 Fengyan Wang,2 Rongchang Chen,2 Zhenyu Liang,2 Yumin Zhou,2 Yuqiong Yang,2 Shengqi Chen,1 Carolina Oi Lam Ung,1 Hao Hu1 1State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao; 2State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou China Purpose: Hospitalization brings considerable economic pressure on COPD patients in China. A clear understanding of hospitalization costs for patients with COPD is warranted to improve treatment strategies and to control costs. Currently, investigation on factors contributing to hospitalization costs for patients with COPD in China is limited. This study aimed to measure the hospitalization costs of COPD and to determine the contributing factors. Patients and methods: Medical record data from the First Affiliated Hospital of Guangzhou Medical University from January 2016 to December 2016 were used for a retrospective analysis. Patients who were hospitalized with a diagnosis of COPD were included. Patient characteristics, medical treatment, and hospitalization costs were analyzed by descriptive statistics and multivariable regression. Results: Among the 1,943 patients included in this study, 87.85% patients were male; the mean (SD) age was 71.15 (9.79) years; 94.49% patients had comorbidities; and 82.30% patients had health insurance. Regarding medical treatment, the mean (SD) length of stay was 9.38 (7.65) days; 11.12% patients underwent surgery; 87.91% used antibiotics; and 4.53% underwent emergency treatment. For hospitalization costs, the mean (SD) of the total costs per COPD patient per admission was 24,372.75 (44,173.87) CNY (3,669.33 [6,650.38] USD), in which Western medicine fee was the biggest contributor (45.53%) followed by diagnosis fee (27.00%) and comprehensive medical fee (12.04%). Regression found that reimbursement (-0.032; 95% CI -0.046 to 0.007), length of stay (0.738; 95% CI 0.832–0.892), comorbidity (0.044; 95% CI 0.029–0.093), surgery (0.145; 95% CI 0.120–0.170), antibiotic use (0.086; 95% CI 0.060–0.107), and emergency treatment (0.121; 95% CI 0.147–0.219) were significantly (P<0.01) associated with total hospitalization costs. Conclusion: To control hospitalization costs for COPD patients in China, the significance of comorbidity, length of stay, antibiotic use, surgery, and emergency treatment suggests the importance of controlling the COPD progression and following clinical guidelines for inpatients. Interventions such as examination of pulmonary function for early detection, quality control of medical treatment, and patient education warrant further investigation. Keywords: COPD, economic burden, hospitalization costs, medical cost, multivariate regressionhttps://www.dovepress.com/factors-contributing-to-hospitalization-costs-for-patients-with-copd-i-peer-reviewed-article-COPDChronic obstructive pulmonary diseasehospitalization costsmedical costCOPDcomorbidityChina
spellingShingle Li M
Wang FY
Chen R
Liang Z
Zhou Y
Yang Y
Chen S
Ung COL
Hu H
Factors contributing to hospitalization costs for patients with COPD in China: a retrospective analysis of medical record data
International Journal of COPD
Chronic obstructive pulmonary disease
hospitalization costs
medical cost
COPD
comorbidity
China
title Factors contributing to hospitalization costs for patients with COPD in China: a retrospective analysis of medical record data
title_full Factors contributing to hospitalization costs for patients with COPD in China: a retrospective analysis of medical record data
title_fullStr Factors contributing to hospitalization costs for patients with COPD in China: a retrospective analysis of medical record data
title_full_unstemmed Factors contributing to hospitalization costs for patients with COPD in China: a retrospective analysis of medical record data
title_short Factors contributing to hospitalization costs for patients with COPD in China: a retrospective analysis of medical record data
title_sort factors contributing to hospitalization costs for patients with copd in china a retrospective analysis of medical record data
topic Chronic obstructive pulmonary disease
hospitalization costs
medical cost
COPD
comorbidity
China
url https://www.dovepress.com/factors-contributing-to-hospitalization-costs-for-patients-with-copd-i-peer-reviewed-article-COPD
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