The Analysis Of The Health Care Resource Utilization And Direct Medical Costs Among Patients With Epilepsy In Tianjin,China

Objective: To explore the trend of health care resource and direct medical costs among the epilepsy patients in Tianjin,and provide policy advices for reducing patient’s economic burden,optimizing the treatment patterns,relieving the stress on health insurance funds.Methods: The patients from Tianjin UEBMI databases(2008-2013)and URRBMI databases(2008-2013)were selected and their health care resource and direct medical costs were analyzed with descriptive analysis,comparisons were further conducted between “refractory” patients and “non-refractory” patients using significance test.We also analysed and compared the differences between “outpatient” patients,“special-outpatient” patients and “both outpatient and special-outpatient” patients.Ordinary least square regression model was applied to identify factors associated with the direct medical costs,Chi-square test and t-test were used to compare the differences between two subgrops.Results: The prevalence of epilepsy patients increased from 2009 to 2013 in UEBMI and URRBMI and was 3.05‰ and 0.95‰ in 2013.For epilepsy-related health services,less than 15% of patients experienced at least one outpatient visit in UEBMI,however,more than 80% of patients experienced at least one outpatient visit in URRBMI.The total direct medical costs per patient were 7211 yuan(2013)in UEBMI,of which 75% were hospitalization costs.The total direct medical costs per patient were 9195 yuan(2013)in URRBMI,of which 50% were special-outpatient costs.In subgroup analysis,both in UEBMI and URRBMI,the refractory patients were more likely to suffered from heavier epilepsy-related economic burden than non-refractory patients(refractory vs non-refractory: 13854 yuan vs 5704 yuan,UEBMI;refractory vs non-refractory: 13985 yuan vs 7995 yuan,URRBMI,2013).The patients who treated epilepsy only by special-outpatient suffered from significant epilepsy-related economic burden than those only by outpatient(special-outpatient vs outpatient: 9228 yua vs 3273 yuan,UEBMI;7718yuan vs 2271 yuan,URREBMI).The regression model revealed age,health status indicated by Quan-Charlson Comobidity Index(CCI)were the mainly influencing factor of cost.Conclusions: The prevalence of epilepsy patients increased over the 5 years,The decrease in the yearly epilepsy-related total direct medical costs was associated with the decrease of the length of hospital stays in UEBMI,however,the epilepsy-related total direct medical costs increased in URREBMI.Refractory epilepsy patients had as twice as much the cost of non-refractory patients.The yonger patients with poor health status would like to suffer from heavier economic burden.