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Background Occupational pneumoconiosis is the most common occupational disease in Qinghai Province and China. From the perspective of public health, it is important to assess the disease burden using disability-adjusted life years (DALY) and economic losses. Objective To evaluate the disease burden of occupational pneumoconiosis in Qinghai Province, and to provide a basis for the formulation and implementation of relevant prevention and control strategies. Methods Based on the registered data, a database of occupational pneumoconiosis cases confirmed and reported in Qinghai Province was established. The survival status and death dateof occupational pneumoconiosis patients from 2015 to 2019 were confirmed by on-site visit, telephone survey, matching search of Death Information Registration and Management System, and consulting other departments. The life loss due to occupational pneumoconiosis from 2015 to 2019 was assessed using DALY as an indicator and data from the Global Burden of Disease 2019 (GBD 2019) study. Inpatients with officially diagnosed occupational pneumoconiosis from a hospital in Qinghai Province in 2019 were selected as study subjects, the direct economic loss was evaluated with hospitalization expenses, and the indirect economic loss due to occupational pneumoconiosis in Qinghai Province in 2019 was calculated by human capital approach. Results From 2015 to 2019, 505 new cases of occupational pneumoconiosis were reported in Qinghai Province, and there were 348 death cases. Prevalent cases and years lost due to disability (YLD) due to occupational pneumoconiosis were increased, while DALY and years of life lost (YLL) due to occupational pneumoconiosis decreased firstly and then increased. In each year, there were 87% or more of the DALY, YLL, or YLD attributed to silicosis and coal workers' pneumoconiosis. In 2019, the occupational pneumoconiosis-associated DALY was 2173.55 person years. The total hospitalization expense incurred by 42 inpatients with occupational pneumoconiosis was 1256345.19 yuan. The total hospitalization expense and average daily cost of the inpatients with stageⅡand Ⅲ pneumoconiosis were higher than that of the inpatients with stageⅠ (P<0.05), and the hospitalization expense was higher in the ≥60 years age group than in the <60 years age group (P<0.05). In 2019, the indirect economic burden incurred by occupational pneumoconiosis in Qinghai Province was 44108581.65 yuan, and accounted for 0.15‰ of the gross domestic product (GDP) of the province. Conclusion The disease burden associated with occupational pneumoconiosis in Qinghai Province are outstanding. Silicosis and coal workers' pneumoconiosis are the key contributors. Targeted intervention measures including dust hazard control, enterprise management, follow-up and rehabilitation management of pneumoconiosis should be taken to prevent and control the occurrence and progression of pneumoconiosis and alleviate disease burden of pneumoconiosis.
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Objective To investigate the direct economic loss of nosocomial infection at a tertiary hospital, so as to provide data support for the improvement of hospital infection control. Methods Inpatients discharged in 2013-2015 period were divided into two groups at a 1:1 pairing ratio, having those suffering from nosocomial infection in only one occasion as the infection group, and those without as the non-infection group. The two groups were compared of their differences in days of stay and hospitalization expenses. Results The days of stay of the infection group were significantly longer than the non-infection group, averaging 6 days longer in terms of the median. Compared with the non-infection group, the total hospitalization cost and the differences with sub-categories other than the treatment cost were of significance. The costs over the non-infection group were mostly contributed by drugs, accounting for 50. 39%, while 23. 50% of which were spent on antibiotics. The additional antibiotics costs were mainly incurred by respiratory tract infections during hospitalization, as the costs of antimicrobial agents for the infection group were 27. 34 times that of the non-infection group. The second contributor was surgical site infection, with the cost of antibiotics 7. 63 times that of the non-infection group. Conclusions Hospital infections prolong the days of stay, increase direct economic loss, especially increase the cost of antibiotics. Prevention and control of respiratory system and surgical site infection can effectively reduce the direct economic loss of hospital infection.
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Objective To investigate the direct economic loss caused by oral infection in patients with acute leuke-mia.Methods Acute leukemia patients with oral infection in a tertiary first-class hospital in Shandong Province be-tween January 2011 and December 2013 were investigated,the 1 :1 matched case-control method was used for com-paring hospitalization expense and length of hospital stay between oral infected (case group)and uninfected patients (control group ).Results A total of 994 patients with acute leukemia were monitored,277 had healthcare-associated infection,17 (5.56%)of whom were with oral infection.The median hospitalization expense of patients in case group and control group was￥37 327 and￥13 176 respectively,the total hospitalization expense of patients in case group was 2.83 times more than control group,difference was statistically significant (Z = -3.621 ,P <0.001).Each hospitalization expense of case group was higher than control group,especially expense for medicine, blood transfusion,laboratory examination,and therapy.The median length of hospital stay in case group and con-trol group were 17 days and 11 days respectively,rank sum test showed that difference in median length of hospital stay between two groups was statistically significant (Z =-3.627,P < 0.001 ).Conclusion Acute leukemia pa-tients with oral infection have increased hospitalization expense,prolonged length of hospital stay,and increased the financial burden.
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Objective To investigate the direct economic losses caused by healthcare-associated infection(HAI)in patients with acute lymphoblastic leukemia (ALL)and acute non-lymphoblastic leukemia (ANLL).Methods All acute leukemia (AL)adult patients who were admitted to a hematology ward in a hospital between January 201 1 and December 2013 were included in the study,HAI group(case group)and non-HAI group (control group),ALL group and ANLL group were matched respectively in a 1:1 ratio,hospitalization expenses and length of hospital stay were compared.Results A total of 994 patients were included,166 were with ALL,828 with ANLL,there were 181 pairs of case group and control group,and 15 pairs of ALL group and ANLL group. Direct economic los-ses in ALL group and ANLL group were 13 089.0 ￥ and 21 565.0 ￥ respectively ;extension of length of hospital stay due to HAI were 10.5 and 10.0 days respectively,differences were statistically significant between case group and control group (both P<0.05). The total hospitalization expense,as well as fees for bed,consultation,treat-ment,laboratory examination,nursing,medicine,traditional Chinese medicine,and blood transfusion in ANLL group were all higher than ALL group,but there were no significant difference.Conclusion HAI in patients with AL can increase hospitalization cost and prolong length of hospital stay.
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Objective To explore the characteristics and their influencing factors of economic burden for pneumoconiosis disease,and to provide a baseline to develop the prevention measures and to reduce the economic burden of pneumoconiosis. Methods The retrospective epidemiological method was used to investigate the general information of pneumoconiosis cases,frequency of outpatient and hospitalization per year,medical expenditure. Direct economic loss and its influencing factors of pneumoconiosis patients were analyzed. Results A total of 421 pneumoconiosis cases were investigated. All subjects were male,including 306 inpatients. The average medical expenditures of outpatient and inpatient were 594. 53 ± 336. 23 and 32 266. 06 ± 28 130. 67 Yuan,respectively. The annual average expenditures of outpatient and inpatient were 2 907. 25 and 48 721. 75 Yuan,respectively. In terms of health care costs,the highest proportion of western medicine was 44. 08% ,followed by traditional Chinese medicine(12. 62% ). With an increase in pneumoconiosis stage,the annual frequency of outpatient and hospitalization,as well as total expenditure increased accordingly. The average annual cost of pneumoconiosis inpatient with complications and non - complication inpatient were 55 822. 20 and 23 532. 21 Yuan,respectively. The annual average cost of outpatient with complications and without complications were 4 236. 41 and 882. 31 Yuan, respectively. The expenditures for pneumoconiosis disease with complications among outpatient and inpatient were significantly higher than those of pneumoconiosis patients without complications(P < 0. 05). Conclusion Direct economic loss of pneumoconiosis disease is relatively high. The disease stage and complications of pneumoconiosis are the main factors influencing the direct economic loss of pneumoconiosis.