PDF(Pubmed)
Abstract：
Economic data on congenital heart disease are scarce in economically underdeveloped areas of China. Therefore, this study aimed to shed light on the level and changing trend of congenital heart disease inpatients\' economic burden in underdeveloped areas.
This study used a multi-stage stratified cluster sampling method to select 11,055 inpatients with congenital heart disease from 197 medical and health institutions in Gansu Province. Their medical records and expenses were obtained from the Hospital Information System. Univariate analysis was conducted using the rank sum test and Spearman rank correlation. Quantile regression and random forest were used to analyze the influencing factors.
From 2015 to 2020, the average length of stay for congenital heart disease patients in Gansu Province was 10.09 days, with an average inpatient cost of USD 3,274.57. During this period, the average inpatient costs per time increased from USD 3,214.85 to USD 3,403.41, while the average daily inpatient costs increased from USD 330.05 to USD 376.56. The average out-of-pocket costs per time decreased from USD 2,305.96 to USD 754.77. The main factors that affected the inpatient costs included length of stay, cardiac procedure, proportion of medications, age, and hospital level.
Congenital heart disease causes a significant economic burden on both families and society. Therefore, to further reduce the patient\'s financial burden, the length of stay should be reasonably reduced, and the rational distribution of medical resources should be continuously promoted to ensure equitable access to healthcare services.
This study used a multi-stage stratified cluster sampling method to select 11,055 inpatients with congenital heart disease from 197 medical and health institutions in Gansu Province. Their medical records and expenses were obtained from the Hospital Information System. Univariate analysis was conducted using the rank sum test and Spearman rank correlation. Quantile regression and random forest were used to analyze the influencing factors.
From 2015 to 2020, the average length of stay for congenital heart disease patients in Gansu Province was 10.09 days, with an average inpatient cost of USD 3,274.57. During this period, the average inpatient costs per time increased from USD 3,214.85 to USD 3,403.41, while the average daily inpatient costs increased from USD 330.05 to USD 376.56. The average out-of-pocket costs per time decreased from USD 2,305.96 to USD 754.77. The main factors that affected the inpatient costs included length of stay, cardiac procedure, proportion of medications, age, and hospital level.
Congenital heart disease causes a significant economic burden on both families and society. Therefore, to further reduce the patient\'s financial burden, the length of stay should be reasonably reduced, and the rational distribution of medical resources should be continuously promoted to ensure equitable access to healthcare services.
摘要：
■在中国经济欠发达地区，有关先天性心脏病的经济数据很少。因此,本研究旨在揭示欠发达地区先天性心脏病住院患者经济负担的水平和变化趋势。
■本研究采用多阶段分层整群抽样方法,从甘肃省197家医疗卫生机构中抽取11,055例先天性心脏病住院患者。他们的医疗记录和费用是从医院信息系统获得的。采用秩和检验和Spearman秩相关进行单因素分析。采用分位数回归和随机森林对影响因素进行分析。
■从2015年到2020年，甘肃省先天性心脏病患者的平均住院时间为10.09天，平均住院费用为3,274.57美元。在此期间,平均每次住院费用从3,214.85美元增加到3,403.41美元,而平均每日住院费用从330.05美元增加到376.56美元.平均每次自付费用从2,305.96美元降至754.77美元。影响住院费用的主要因素包括住院时间，心脏手术,药物的比例，年龄,医院级别。
先天性心脏病对家庭和社会造成了巨大的经济负担。因此,进一步减轻患者的经济负担,应合理缩短逗留时间，应继续促进医疗资源的合理分配，以确保公平获得医疗保健服务。
■本研究采用多阶段分层整群抽样方法,从甘肃省197家医疗卫生机构中抽取11,055例先天性心脏病住院患者。他们的医疗记录和费用是从医院信息系统获得的。采用秩和检验和Spearman秩相关进行单因素分析。采用分位数回归和随机森林对影响因素进行分析。
■从2015年到2020年，甘肃省先天性心脏病患者的平均住院时间为10.09天，平均住院费用为3,274.57美元。在此期间,平均每次住院费用从3,214.85美元增加到3,403.41美元,而平均每日住院费用从330.05美元增加到376.56美元.平均每次自付费用从2,305.96美元降至754.77美元。影响住院费用的主要因素包括住院时间，心脏手术,药物的比例，年龄,医院级别。
先天性心脏病对家庭和社会造成了巨大的经济负担。因此,进一步减轻患者的经济负担,应合理缩短逗留时间，应继续促进医疗资源的合理分配，以确保公平获得医疗保健服务。
