Data_Sheet_1_Study on the trend of congenital heart disease inpatient costs and its influencing factors in economically underdeveloped areas of China, 2015–2020: a case study of Gansu Province.pdf

BackgroundEconomic data on congenital heart disease are scarce in economically underdeveloped areas of China. Therefore, this study aimed to shed light on the level and changing trend of congenital heart disease inpatients' economic burden in underdeveloped areas.
MethodThis study used a multi-stage stratified cluster sampling method to select 11,055 inpatients with congenital heart disease from 197 medical and health institutions in Gansu Province. Their medical records and expenses were obtained from the Hospital Information System. Univariate analysis was conducted using the rank sum test and Spearman rank correlation. Quantile regression and random forest were used to analyze the influencing factors.
ResultsFrom 2015 to 2020, the average length of stay for congenital heart disease patients in Gansu Province was 10.09 days, with an average inpatient cost of USD 3,274.57. During this period, the average inpatient costs per time increased from USD 3,214.85 to USD 3,403.41, while the average daily inpatient costs increased from USD 330.05 to USD 376.56. The average out-of-pocket costs per time decreased from USD 2,305.96 to USD 754.77. The main factors that affected the inpatient costs included length of stay, cardiac procedure, proportion of medications, age, and hospital level.
ConclusionCongenital heart disease causes a significant economic burden on both families and society. Therefore, to further reduce the patient's financial burden, the length of stay should be reasonably reduced, and the rational distribution of medical resources should be continuously promoted to ensure equitable access to healthcare services.

背景
中国经济欠发达地区先天性心脏病（congenital heart disease）相关经济数据较为匮乏。本研究旨在阐明该类地区先天性心脏病住院患者经济负担的水平及其变化趋势。
方法
本研究采用多阶段分层整群抽样方法，从甘肃省197家医疗卫生机构中纳入11055名先天性心脏病住院患者。通过医院信息系统（Hospital Information System）获取其病历资料与费用数据。采用秩和检验（rank sum test）与斯皮尔曼秩相关（Spearman rank correlation）开展单因素分析，运用分位数回归（quantile regression）与随机森林（random forest）分析影响因素。
结果
2015年至2020年，甘肃省先天性心脏病患者的平均住院时长为10.09天，平均住院总费用为3274.57美元。在此期间，患者单次住院总费用从3214.85美元升至3403.41美元，日均住院费用从330.05美元升至376.56美元，而单次自付费用则从2305.96美元降至754.77美元。影响住院费用的主要因素包括住院时长、心脏手术（cardiac procedure）、药物占比、患者年龄与医院等级。
结论
先天性心脏病给患者家庭与社会均造成了显著的经济负担。因此，为进一步减轻患者的经济负担，应合理缩短住院时长，持续推动医疗资源的合理配置，以保障医疗服务的公平可及性。