Abstract
Background and Purpose: Studies on the regional differences in hospital costs of acute ischemic stroke (AIS) are scarce in China. We aimed to explore the regional differences in hospital costs and identify the determinants of hospital costs in each region.Methods: Data were collected from the Chinese Acute Ischemic Stroke Treatment Outcome Registry (CASTOR), a multicenter prospective study on patients diagnosed with AIS and hospitalized from 2015 to 2017. Univariate and multivariate analyses were undertaken to identify the determinants of hospital costs of AIS.Results: A total of 8,547 patients were included in the study, of whom 3,700 were from the eastern area, 2,534 were from the northeastern area, 1,819 were from the central area, and 494 were from the western area. The median hospital costs presented a significant difference among each region, which were 2175.9, 2175.1, 2477.7, and 2282.4 dollars in each area, respectively. Each region showed a similar hospital cost proportion size order of cost components, which was Western medicine costs, other costs, diagnostic costs, and traditional medicine costs, in descending order. Male sex, diabetes mellitus, severe stroke symptoms, longer length of stay, admission to the intensive care unit, in-hospital complications of hemorrhage, and thrombectomy were independently associated with hospital costs in most regions.Conclusion: Hospital costs in different regions showed a similar proportion size order of components in China. Each region had different determinants of hospital costs, which reflected its current medical conditions and provided potential determinants for increasing medical efficiency according to each region's situation.
Highlights
As the second leading cause of death and third leading cause of disability globally, stroke places an enormous burden on current health care and social costs [1]
Data were obtained from the Chinese Acute Ischemic Stroke Treatment Outcome Registry (CASTOR), a multicenter prospective study that included 10,002 cases of acute ischemic stroke (AIS) from 80 hospitals in 44 cities across mainland China
The inclusion criteria for patients were [1] age ≥18 years; [2] diagnosis of AIS confirmed by computed tomography (CT) or magnetic resonance imaging (MRI) from May 2015 to October 2017; and [3] admission to a hospital within 7 days of onset of AIS
Summary
As the second leading cause of death and third leading cause of disability globally, stroke places an enormous burden on current health care and social costs [1]. Several studies have been conducted to identify the determinants of hospital costs of acute ischemic stroke (AIS) in mainland China [4,5,6,7,8,9,10,11,12]. No study has sought to identify the regional differences in hospital costs considering the huge geographic and socioeconomic differences among regions in China. We aimed to explore regional differences in hospital costs of AIS and identify each region’s potential determinants for increasing medical efficiency in China. Studies on the regional differences in hospital costs of acute ischemic stroke (AIS) are scarce in China. We aimed to explore the regional differences in hospital costs and identify the determinants of hospital costs in each region
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