珠海市两家三级甲等医院缺血性脑卒中患者的住院费用及其影响因素OA

Objective To analyze the total inpatient costs,out-of-pocket spending,and cost composition of total inpatient costs for patients with ischemic stroke(IS),and to explore the main factors influencing total inpatient costs and out-of-pocket spending,so as to provide a basis for alleviating the economic burden on IS patients.Methods Inpatient data from 9 944 IS patients treated at two tertiary Grade A hospitals in Zhuhai,Guangdong Province,from 2019 to 2024 were collected.Descriptive statistics were conducted to analyze total inpatient costs,out-of-pocket spending,and the composition of total inpatient costs.Based on the Andersen model,factors influencing total inpatient costs and out-of-pocket spending were explored from three dimensions:predisposing factors,enabling factors,and need factors.After natural logarithm transformation,ordinary least squares regression was employed to identify the influencing factors.Results The average total inpatient cost per visit for IS patients was CNY 22 513.11,with a median of CNY 12 690.32.Treatment costs accounted for the highest proportion at 47.83%.The average out-of-pocket spending per visit was CNY 13 123.04,with a median of CNY 7 189.59,accounting for 58.29%of total inpatient costs.Regression analysis indicated that age,gender,type of medical insurance,chronic disease status,receipt of surgery,and length of stay were significant factors affecting total inpatient costs;gender,type of medical insurance,chronic disease status,receipt of surgery,and length of stay were significant factors influencing out-of-pocket spending(all P<0.05).Conclusions Both total inpatient costs and out-of-pocket spending for IS patients are high.Need factors such as chronic disease status,receipt of surgery,and length of stay are the main influencing factors.It is recommended to further develop community-based stroke rehabilitation centers and establish long-term care insurance systems to reduce the financial burden on IS patients.