Analysis of the hospitalization costs of surgical patients with congenital heart disease in the plateau region of western China, 2010-2019

J Thorac Dis. 2023 Nov 30;15(11):6192-6204. doi: 10.21037/jtd-23-1246. Epub 2023 Nov 27.

Abstract

Background: Congenital heart disease (CHD) is one of the most common birth defects and consumes a substantial amount of health care resources. CHD leads to heavy economic burdens for families. However, there are limited data regarding the utilization of healthcare resources for CHD. The objectives of this study were to evaluate the composition, changing trends, and factors affecting hospitalization costs for patients with CHD in the western highlands area of China over a 10-year period.

Methods: We conducted a study using the International Quality Improvement Collaborative for Congenital Heart Surgery (IQIC) database and information management system of The First Hospital of Lanzhou University between January 2010 and December 2019.

Results: Among 3,087 patients hospitalized for CHD surgery, annual CHD hospitalization costs saw an increasing trend over the 10-year period, with an average growth rate of 4.6% per year. The major contributors to the hospitalization costs were surgery, surgical material, and drug costs. Length of stay (β=0.203; 0.379; 0.474, P<0.01), age at hospitalization (β=0.293, P<0.01), proportion of surgery (β=0.090; -0.102; -0.122; -0.110, P<0.01) and drug costs (β=-0.114; -0.147; -0.069, P<0.01), and use of traditional Chinese medicine (β=0.141, P<0.01) were independent factors affecting average hospitalization costs.

Conclusions: The financial burden of patients with CHD in the Chinese western highland region is high. Independent of inflation, CHD hospitalization costs are increasing. Measures taken by medical institutions to control the increase in drug costs, and to shorten the length of stay may be expected to have positive effects on reducing the financial burden of individuals with CHD and their families.

Keywords: Congenital heart disease (CHD); hospitalization costs; influencing factors; length of stay; random forest model.