Difference of hospital charges for stroke inpatients between hospitals with different levels and therapeutic modes in Beijing, China

摘要

Objectives: The present study analyzed the hospital charges for stroke patients in China and determined the factors associated with hospital costs. Methods: Medical records of hospitalized patients with a primary diagnosis of acute stroke were collected from 121 hospitals in Beijing (2012). Distribution characteristics of hospital charges for different stroke types, hospital levels and types were studied. Factors influencing total hospital charges were analyzed. Results: 60.8% of the 94906 stroke patients were male and the mean age of these patients was 66.5 +/- 13.2years. The median length of hospital stay (LOHS) for these patients was 14 d (interquartile range, IQR 9-19). The mean hospital charge per patient was 19270 Chinese Yuan. Forty-five percent of these charges were for medicine, 18% for laboratory and examination, 16% for material, 15% for therapy, 5% for service and 1% for blood product. The mean hospital charge for patients suffering from hemorrhagic stroke was significantly more than ischemic stroke (34937vs. 17049, p 0.001), and was significantly more for Level 3 than Level 2 hospitals (23762vs. 14554, p 0.001). LOHS, hospital level and stroke severity were key determinants of the hospital charge. Conclusions: Though hospital charges for stroke patients in China were low, it brought a heavy economic burden for the larger stroke population. Medicine accounted for the largest percentage of hospital charges in China. LOHS emerged to be the main predictor of the cost. Decreasing medicine charge and LOHS might be strategies to decrease hospital charges and reduce economic burden of stroke in China.