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Variations and determinants of hospital costs for acute stroke in China

Jade W Wei1, Emma L Heeley, Stephen Jan

  • 1The George Institute for Global Health, Royal Prince Alfred Hospital and University of Sydney, Sydney, Australia. jwei@george.org.au

Plos One
|October 8, 2010
PubMed

Insights

Reducing hospital length of stay (LOS) for acute stroke patients in China could significantly cut costs. Standardizing resource use and improving hospital policies are key to managing stroke care expenses.

Area of Science:

  • Health Economics
  • Public Health
  • Stroke Medicine

Background:

  • The incidence and economic burden of stroke are rising in China.
  • Acute stroke care costs represent a significant financial challenge.

Purpose of the Study:

  • To model variations and identify predictors of hospital care costs for acute stroke patients in China.
  • To assess the potential cost savings from reducing length of stay (LOS).

Main Methods:

  • Prospective register-based study (ChinaQUEST) of 5,255 acute stroke patients.
  • Data collected from 48 Level 3 and 14 Level 2 hospitals (2006-2007).
  • Ordinary least squares regression used to analyze factors influencing hospital costs.

Main Results:

  • Mean hospitalization cost was 11,216 CNY (≈US$1,602) per patient, over half the average annual wage.
  • Stroke severity and LOS were primary cost drivers.
  • Reducing LOS to one week could decrease costs by 49% (Level 3) and 19% (Level 2).
  • Health insurance and complications increased costs in Level 3 hospitals; teaching hospital status decreased costs.
  • Intracerebral hemorrhage stroke was more costly than ischemic stroke in Level 2 hospitals.

Conclusions:

  • Standardizing resource use and reducing LOS variation can lower acute stroke care costs in China.
  • Policy changes targeting hospital reimbursement systems can enhance cost-saving strategies.
  • Improving hospital efficiencies is crucial for managing the growing stroke burden.
Abstract

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