Factors Associated With Hospitalization Costs of Coronary Heart Disease in Township Hospitals in Rural China

Abstract

In large proportions of rural areas in many developing countries, health care delivery system is less developed and is less likely to be equipped to conduct sophisticated treatment for coronary heart disease (CHD) patients locally. This study aims at describing the status quo of and exploring factors associated with hospitalization costs of CHD in township hospitals where only drug therapy was available for CHD conditions. We collected data of inpatients with CHD from discharge records from 10 township hospitals in rural Liaoning from December 2013 to December 2014. We used multilevel linear regression to analyze the factors associated with CHD hospitalization costs. A total of 4635 inpatients were included in the analysis. We found that the average hospitalization costs were 6249.97 RMB (US$1012.47) with the average of 8.89 days of hospitalization in township hospitals in Liaoning. Age, gender, length of stay, the number of times of admissions, by which route was hospitalized, and type of CHD were all the factors significantly associated with hospitalization costs of CHD in township hospitals. The factors associated with hospitalization costs of CHD in township hospitals in rural China showed some different features from the existing studies. When the government designs the related policy, the policy makers need to consider the specific feature of hospitalization costs of CHD in township hospitals in rural areas.

Hospitalization Expenses and Influencing Factors for Inpatients with Ischemic Heart Disease in Iran: A Retrospective Study

“…Our findings revealed a higher hospitalization cost among men than women, which was supported by previous studies (15,31,32,35). Since men have more unhealthy life habits compared to women in Iran (eg, smoking and drinking alcoholic beverages), they have various underlying diseases and more severe CVDs (36).…”

“…The mean LOS for patients with IHD was reported as 4.92 days, which was close to the mean LOS for patients with CHD in China (4 days) (32) and United States (4.9 days) (38). However, some studies claimed longer mean LOS (31,35). The LOS was significantly associated with the higher hospitalization costs, which was similar to some previous studies (31,32,39).…”

“…However, some studies claimed longer mean LOS (31,35). The LOS was significantly associated with the higher hospitalization costs, which was similar to some previous studies (31,32,39). Patients with excess hospitalization days had more critical illnesses, further comorbidity, and higher risk factors.…”

“…Since the costs were based on the approved tariffs in this study, they were lower than the actual values. In some other studies conducted in the rural areas of China (31), urban areas of China (32), and Shanghai (33), the mean hospitalization costs of patients with chronic heart diseases was reported at 1012.47 USD, 6791.38 USD, and 2546.59 USD, respectively, which were also higher than those presented in our study. This might be due to the fact that these studies estimated the hospitalization costs of patients with chronic heart diseases, including myocardial infarction, angina pectoris, and IHD, but our research considered only patients with IHD.…”

“…According to the findings, the age groups below 80 were significantly correlated with the increased hospitalization costs, which were much higher in patients aged 51 -60 and 61 -70 years old by 37% and 38%, respectively. Other studies also reported that younger patients had higher hospitalization costs than their older peers (31,33,37); this might be attributed to the fact that old patients selected relatively conservative treatments such as fewer cardiac stents, less aggressive therapies, and more drugs (32). There were also significant differences between the hospital costs in terms of their accreditation grades.…”