Assessing The Direct Economic Burden Of Chronic Obstructive Pulmonary Disease In Sichuan Province

Objective: To analyze chronic obstructive pulmonary disease(COPD)among inpatients in Sichuan Province by using information of inpatient face sheet.The different groups of COPD hospitalization characters,and the cost composition and distribution are described in this study.The main factors affecting inpatients' direct economic burden are distinguished.To understand the direct hospitalization expenses of COPD inpatients in Sichuan Province,and evaluating direct economic burden of COPD.This study also aims to provide evidences for controlling hospitalization expenditure,effectively improving healthcare service and medical resources allocation in Sichuan Province.Methods: This study is a population-based study,using the inpatient face sheet in Sichuan Province in 2017 that includes both the categories of Western Medicine and Traditional Chinese Medicine cases.Using the ICD-10 disease code,982,220 cases with discharged diagnosis as COPD are extracted.We analyzed demographic characteristics,hospitalization treatment process and hospitalization expenditure including average inpatient cost,average out of pocket cost and length of stay.The main factors affecting the total hospitalization cost of patients were analyzed by Generalized Linear Model(GLM)regression.Conclusions: The COPD inpatients of Sichuan Province are mainly male and farmers.The aging trend and geographical distribution difference are obvious.Male patients accounted for 64% of total cases;farmers accounted for 61%;and the average age of patients is 71 years old.The severities of patients from western areas of Sichuan Province are relatively high.The average length of hospital stay is 9.44 days.Around 67% of the patients were admitted to hospital in a median severity condition.Among them,16921 patients have been transferred.The proportion of patients transferred to higher-level of medical organizations was 1.23%,and the proportion of transferred to lower-level community health service institutions and rural township hospitals was 0.49%.The costs of western medicine are the largest proportion of total costs and are the main components of the direct economic burden of patients,which accounted for 38.32% of the total medical expenses.The main factors of direct inpatient cost are consists of the gender,occupation type,age,medical institution type and disease severity.Suggestions: Based on the results,we suggest to efficiently allocating medical resources to improve health service accessibility,to strengthen the awareness of disease prevention on population level,to improve qualified primary care medical service,to promote two-way referral system mechanism,and to facilitate the medical information construction.