Study On Economic Burden Of Congenital Heart Disease In Surgical Treatment Inpatient And Time Series Analysis Of Hospitalization Costs Prediction

Objective:To understand the economic burden of congenital heart disease(CHD) and itsinfluencing factors from social view sight in order to give suggestions to healthadministrative departments for allocating of limited health resources rationally andmake correct health economic decisions.Time series analysis was used to predict the hospitalization cost of CHD in orderto give suggestions for its prevention, control and cost control strategy of singlediseases for our country.Methods:Period of consecutive cases cluster sampling method was used to investigate theeconomical burden of congenital heart disease. Direct medical burden wasacquaintance by hospital cost data in medical record and related information;questionnaire for direct non-medical burden and human capital approach forcalculation of indirect costs. Mean, median and interquartile range were used fordescription of quantitative data;T-test was used for means of quantitative data. If itisn’t normal distribution, Kruskal-Wallis test will be used. Positive rate or constituentratio were used for statistics of qualitative data and Chi-square test was used forcomparison among groups. Rank correlation analysis Was used for tendency ofranked data. Orderly logistic regression was used for research of influencing factor.Exponential Smoothing and Auto-regressive moving average were modeled by the hospitalization costs of patient with ASD or VSD from2002to2013. The sum ofsquared residuals is minimal was used as the critical to select best model. Then,Predictive value of2013was fitted by the two models separately; eventually, the mostsuitable prediction model was determined by the relative error between predictedvalue and the real one.SAS9.2was used for data analysis.Results:The mean cost of886cases of CHD in our study was41944RMB, of which thedirect cost was39917RMB and indirect costs of1320RMB. The direct non-medicalcost was4640RMB and direct medical cost was34558RMB. In several commoncongenital heart diseases, the highest cost was found in patients with transposition ofconducting arteries, which was76612RMB, patients with single ventricle camesecondly with a cost of65801RMB, while the least cost was found in patients withASD, which was32507RMB.Operation Fee occupied the largest proportion (>50%)in direct non-medical costs.The mean monthly cost of ASD and VSD in2013are26,709RMBand29870RMB, which decline5.03%and increase2.01%compared with2012,respectively. The mean square error(MSE)when exponential smoothing wasused for monthly cost of ASD and VSD are5.09%and2.90%,which are lower thanARMA model.When it comes to different months, exponential smoothing was mostaccurate when used for ASD cost in August, and June for ARMA model. Whendifferent diseases was considered, both exponential smoothing and ARMA modelhave a better prediction accuracy when predicting month cost of VSD compared toASD.Conclusions:The five subtype of CHD were VSD, Tetralogy of Fallot,ASD, single ventricle and transposition of conducting arteries.Patients with congenital heart disease were under huge economic burden becauseof the poor family economic conditions. The economic burden of congenital heart disease is large, of which directeconomic dominatesThe factors that influence total economic burden and direct economic burden ofCHD are length of hospitalization, time at intensive care unit, catheter examination ortreatment, subtypes of CHD,age of patient and disease emergency or not at thebeginning to the hospital. Indirect economic burden was influenced by length ofhospitalization, areas that recent lives and annual family income.Hospitalization costs slight gains in recent years.ARMA has higher prediction accuracy than exponential smoothing whenpredicting hospitalization cost of ASD or VSD.