RESUMEN
OBJECT IVE To investigate the influential factors of direct economic burden of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）patients in hospital ，and to provide related suggestions to reduce the direct economic burden of hospitalization. METHODS During Dec. 1st，2019-Oct. 31st，2020，the data of 1 923 AECOPD patients admitted into the First Affiliated Hospital of Guangzhou Medical University were collected. The information of demographic sociological characteristics，clinical characteristics and cost characteristics were collected ；descriptive analysis ，single factor regression analysis and multiple linear stepwise regression analysis were adopted to investigate the influential factors of direct economic burden of hospitalization. On the basis of literature review ，relevant suggestions were put forward to reduce the direct economic burden of AECOPD patients in hospital. RESULTS & CONCLUSIONS The median of hospitalization cost of AECOPD patients was 15 621.00 yuan. The multiple linear stepwise analysis regression analysis revealed that the influential factors of direct economic burden of AECOPD patients in descending order （by partial regression coefficient ）were the length of stay （logarithmic conversion value ）， admission to ICU ，surgical treatment ，discharge outcome ，whether to salvage ，the use of respirator ，common complications and smoking history （model F＝572.200，R2＝0.750，P＜0.001）. It is suggested to strengthen comprehensive hospital management and promote multidisciplinary cooperation to reduce hospitalization days ；strictly follow the diagnosis and treatment guidelines and clinical pathways to avoid deterioration of the condition and transfer to ICU treatment ；control indications for surgery to avoid“ask for great treatment with only miner illness ”；do a good job in the publicity and education of disease and smoking cessation ，and improve the self-management ability of patients.
RESUMEN
Objective To analyze the direct economic burden and average hospitalization cost of lung cancer in China from 2011 to 2015, to provide data support for the prevention and control of lung cancer and health insurance policies. Methods By using inpatient medical record home page dataset to estimate the total hospital expenses of lung cancer. Using the outpatient hospitalization cost ratio of cancer specialized hospitals to estimate the overall medical expenses of lung cancer. Based on the inpatient medical record home page dataset, and analyzed the average hospitalization cost of lung cancer. Results The total cost of lung cancer in China reached 24.31 billion yuan in 2015, accounting for about 0.6％ of the total health expenses; from 2011 to 2015, lung cancer medical costs have concentrated in the grade 3 general hospitals; people over 60 consumed the major medical costs of lung cancer and the proportion was still rising year by year; the average hospitalization cost of lung cancer was reduced in 2015; drug proportion in various hospitals declined steadily from 2011 to 2015; the average hospitalization cost was the highest in the 18 -40 age group. Conclusion The effect of health care reform was gradually revealed, and the increase of medical expenses was controlled within the tolerable range. Notably, we should accelerate the improvement of the price compensation mechanism, and at the same time, we should aim to improve the level of catastrophic health care for the elderly.
RESUMEN
Objective:To explore the curative care expenditure of the elderly(above 65 years old) in Jilin based on analyzing the economic burden of the elderly.Methods:Based on the System of Health Accounts 2011(SHA2011).it estimated the total curative care expenditure and constitute of the elderly in Jilin.Results:In 2014,the curative care expenditure of the elderly in Jilin reached to 12.85 billion yuan,which accounted for 26.26％ of curative care expenditure of the total population in Jilin.The per capita curative care expenditure of the elderly was 3.01 times of the per capita curative care expenditure of the 0-14 year-old group,2.87 times of the per capita curative care expenditure of the 15-64 year-old group and 2.39 times of the overall per capita curative care expenditure of residents in Jilin.From the perspective of service composition,the elderly treatment costs occurred more in the hospital with the increase in age.From the perspective of disease costs,the elderly treatment costs mainly occurred in the circulatory system diseases,respiratory diseases,cancer and other chronic diseases.The household out-of-pocket (OOP) accounted for 41.83％ in curative care financing for the elderly.Conclusion:The constitute of the curative expense of the elderly in Jilin province had significant characteristics,showed as heavy OOP burden.It needed to provide policy support.
RESUMEN
Objective To understand the direct economic burden of healthcare-associated infection(HAI)due to multidrug-resistant organisms(MDROs).Methods Computer retrieval of CNKI,Wanfang,VIP,PubMed,Sci-enceDirect,and Cochrane databases on literatures about economic burden of MDRO HAI at home and abroad were performed,the retrieval time was from database establishment to December 2015,systematic evaluation of the liter-atures was obtained.Results According to the inclusion and exclusion criteria,as well as through Newcastle-Otta-wa Scale (NOS)for evaluating the literatures,19 literatures were included.In 12 studies about methicillin-resistant Staphylococcusaureus infection,the direct economic cost varied from $916.61 to $62908.00;in 4 studies about MDRO Acinetobacterbaumannii infection,the direct economic cost varied from$4644.00 to $98575.00.Direct economic cost due to extended-spectrumβ-lactamases-producing Enterobacteriaceae was $2824.14-$30093.00. Conclusion MDRO HAI will increase economic cost of both hospitals and patients,prevention and control measures should be taken .
RESUMEN
Objective To evaluate the status and trend of direct economic burden on cerebrovascular disease,from 1993 to 2008 in China.Methods Using two-step model to calculate the economic cost with related trend of cerebrovascular disease within the population among the over 30-year-olds,from 1993 to 2008.Data was gathered from the National Health Service Surveys Analysis Reports of 1993,1998,2003 and 2008,that including both direct outpatient and inpatient cost.Results There appeared a significant increase on the burden of cerebrovascular diseases in the period of 15 years,with direct economic cost increasing from 8.473 billion to 103.125 billion RMB.In fact,the actual increase was 5.3 times,without the influence of the price.The average annual growth rate was 13.1％,exceeding the rate of total expenditure on health and GDP during the same time span.In addition,the growth rate in 2003-2008 was the fastest,which appeared to be 19.8％.Conclusion Burden that caused by cerebrovascular disease on individuals and the whole society was heavy which warrented further theoratical and practical studies on it.
RESUMEN
Objective To compare the medical expenditure and its trend for diabetes mellitus and non-diabetes mellitus and to assess the direct economic burden of diabetes for individuals and families.Methods Using data from the China Health and Nutrition Survey (CHNS),propensity scores matching (PSM) was used to match diabetes mellitus and non-diabetes mellitus according to the related characteristic variables.Data from 679 pairs of objects was then compared.Results From 2000 to 2009,gaps of annual medical expenditure from diabetes mellitus and non-diabetes mellitus showed an increase,from 3361.93 to 6608.48 Yuan,with the ratios of medical expenditure about 4 times.The ratios of personal economic burden and family economic burden had an increase of about 4-5 times.Conclusion Compared with non-diabetes mellitus,the annual medical expenses was significantly higher among patients with diabetes mellitus.The absolute cost appeared a dramatic increase,along with the personal and familiar economic burden.