Objective To investigate the factors affecting hospitalization costs of hospitalized patients with chronic obstructive pulmonary disease (COPD), so as to reduce the burden of patients, promote the rational allocation of medical resources, and provide a basis for formulating healthcare policies.
Methods The medical record homepage data of chronic obstructive pulmonary hospitalized patients in a tertiary general hospital in Beijing from 2019 to 2022 were selected to study the influencing factors of the hospitalization costs through descriptive analysis, rank sum test, correlation analysis, and multifactor regression analysis.
Results Male patients (66.0%) outnumbered female patients (34.0%) among 1 053 COPD patients, the proportion of patients aged 60-89 years old was the highest (82.8%), the number of medicare-paid patients was the highest (88.2%), emergency admissions (57.1%) were higher than outpatient admissions (42.9%), and the percentage of hospitalization days with 10-19 days was the the most (45.3%). The high incidence seasons of chronic obstructive pulmonary disease were fall and winter (51.9%), and common comorbidities were coronary heart disease (78.3%), hypertension (73.0%), and pulmonary heart disease (48.5%). Chinese and Western medicine (36.75%), medical services (29.57%), and diagnosis (22.82%) accounted for the largest share of hospitalization costs. There was a statistical difference in hospitalization costs for variables of age, medical payment method, number of hospitalization days, comorbidities of hypertension, coronary heart disease, respiratory failure, pulmonary heart disease, treatment with antimicrobials, and ventilator-assisted therapy (P<0.05) . Regression analysis showed that the older the age, the longer the hospitalization days, the higher the number of comorbidities, the more use of antimicrobial drugs and ventilator therapy, the higher the hospitalization costs. Compared to medical insurance patients, public medical care was positively correlated with hospitalization costs (P<0.05).
Conclusion Health education should be strengthened, early screening and intervention for elderly patients and COPD patients with a history of cardiovascular disease should be carried out, and multidisciplinary diagnostic and treatment modes and improved clinical pathways should be utilized to standardize the diagnostic and treatment processes, logically shorten the average number of hospitalization days, reduce the waste of medical resources and alleviate the patients′ economic burden.
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