Evaluation of admission characteristics, hospital length of stay and costs for cerebral infarction in a medium-sized city in China.
OBJECTIVE
Stroke is a heavy economic and health burden for the patients and society. This study aimed to evaluate hospital length of stay (LOS) by admission characteristics and costs correlated with medical insurance status for cerebral infarction in a medium-sized city in China.


METHODS
A total of 557 consecutive patients with principal diagnosis of cerebral infarction were enrolled. Admission characteristics, LOS, and costs were retrospectively analyzed.


RESULTS
The mean LOS was 18.5 days (median, 16 days). Our analysis demonstrated that medical insurance status, stroke severity (National Institutes of Health Stroke Scale score, Functional Independence Measure cognitive and motor score, Glasgow coma scale), Oxfordshire Community Stroke Project (OCSP) classification, some comorbidities (coronary heart disease, chronic obstructive pulmonary disease, and hyperlipemia), and raised leukocytes were the main explanatory factors for LOS by stepwise multiple regression model. The mean per patient costs were US $983.0, and mean daily costs US $67.0. Drugs were the most expensive cost subtype, all subtypes costs except non-medical care were significantly higher in patients with state medicine than in those with new cooperative medical scheme (NCMS) (P < 0.001).


CONCLUSIONS
Stroke severity, OCSP classification, raised leukocytes on admission, some comorbidities, and medical insurance status may help to predict LOS for patients with cerebral infarction. Healthcare expenditures were heavy burdens to inhabitants. State medicine patients could shorten unnecessary LOS to improve the resources allocation and cost-efficiency.
Ma
Y
Y
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong Department of Forensic Medicine, North Sichuan Medical College, Nanchong, P. R. China.
Liu
Y
Y
Fu
H-M
HM
Wang
X-M
XM
Wu
B-H
BH
Wang
S-X
SX
Peng
G-G
GG
D000368:Aged; D002544:Cerebral Infarction / Q000191:economics* / Q000453:epidemiology / Q000534:rehabilitation*; D002681:China; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data / Q000639:trends; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health / Q000706:statistics & numerical data / Q000639:trends; D007902:Length of Stay / Q000706:statistics & numerical data / Q000639:trends; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012720:Severity of Illness Index