Care And Charges For Peptic Ulcer With Hemorrhage Inpatients: A Hospital Based Study In Suzhou

Objective:Peptic ulcer with hemorrhage is still a life-threatening disease. The objective of thepresent study is to evaluate the current status of charges about peptic ulcer withhemorrhage, and to identify the main determinants of such charges in a university affiliatedhospital.Methods:In this retrospective study, the patients suffering from peptic ulcer with bleedingduring August2009to December2013in the second affiliated hospital of Soochowuniversity were considered. The associations of different factors with patient charges wereanalysed using a univariate analysis, such as demographic characteristics, medical history,clinical manifestation, diagnosis and treatment during hospitalization and hospital length ofstay.Results:The mean hospital charge per patient was￥6338.8, of which55.6%was attributed tothe charges for medicine,14.4%for laboratory tests,7.4%for imaging studies includingX-ray, ECG and gastroscopy,9.3%for the clinic care expenses, and others accounted for13.3%. The mean initial full Rockall scores on admission were2.47±1.31points, rangingfrom1to5points. The mean hospital length of stay (LOS) was7.5days. All patientsunderwent gastroscopy examination within72hours. Among the799patients,63.2%wereduodenal ulcer with hemorrhage. Gastric ulcer with hemorrhage account for29.4%, whilecombined DU and GU with hemorrhage for6.0%and anastomotic ulcer for1.3%. Benign esophageal ulcer with hemorrhage accounted for0.1%.Conclusion:Total hospital charges were correlated strongly with LOS, age, hemoglobin onadmission, and Forrest classification under gastroscopy, history of taking NSAIDs. Clinicalmanifestation (such as melena or hemotemesis), Hp infection as well as the type of ulcer,the history of peptic ulcer and the diameter of the ulcer did not influence total chargesindependently. The study found that proton pump inhibitors (PPIs) accounted for23.1%oftotal costs. A treatment protocol in peptic ulcer with bleeding may optimize cost, especiallywith regard to the rational use of PPIs. These factors can only explain53.3%of inpatientshospital charges. There are other factors that affect the total charge of hospitalization,which needs further study.