title: Treatment, monitoring, and economic outcomes of venous thromboembolism among hospitalized patients in China.
abstract: BACKGROUND
  The prevalence of venous thromboembolism (VTE) has been increasing in China. However, the treatment pattern and economic burden of these patients have not been well-understood.
  
  
  OBJECTIVE
  The objective of this study was to examine the patient characteristics, treatment pattern, anticoagulant monitoring, and economic burden of VTE among hospitalized patients in China.
  
  
  METHODS
  Hospitalizations with a diagnosis of VTE [including deep vein thrombosis (DVT) or pulmonary embolism (PE)] between 1 January 2010 and 30 June 2013 were included. Descriptive analysis was conducted for patients' characteristics, anticoagulant treatment, international normalized ratio (INR) monitoring, and hospitalization cost [in 2013 Chinese yuan (Y) and US dollars (US$)]. Multivariate regressions were performed to assess factors associated with oral anticoagulant use and total costs of inpatient care.
  
  
  RESULTS
  A total of 1,047 VTE-related hospitalizations were selected. The sample had a mean age of 62.4 years, with 45.9 % female. About 46.3 % of hospitalizations used heparin only, 35.0 % used warfarin, 0.8 % used rivaroxaban, and 18.0 % did not use anticoagulants. Among hospitalizations where warfarin was used, 90.8 % received at least one INR test and only 30 % had the last INR within the target therapeutic range (2-3) before discharge. The mean (standard deviation) total cost per hospitalization was Y29,114 (43,772) [US$4,757 (7,152)]. PE, VTE as primary diagnosis, female, insurance coverage, anticoagulant treatment, co-morbidities, admission condition, and surgical procedure were significantly associated with inpatient costs.
  
  
  CONCLUSIONS
  Conventional anticoagulants were most commonly used in the study sample. Under-monitoring and suboptimal care may be an issue for patients treated with warfarin. The average total inpatient cost of VTE-related hospitalizations is high.
authors: Analysis Group, Inc., 111 Huntington Avenue, 10th Floor, Boston, MA, 02199, USA, ewu@analysisgroup.com.
authors: Eric Q
authors: EQ
authors: Wu
authors: Jipan
authors: J
authors: Xie
authors: Chun
authors: C
authors: Wu
authors: Ella Xiaoyan
authors: EX
authors: Du
authors: Nanxin
authors: N
authors: Li
authors: Ruoding
authors: R
authors: Tan
authors: Yuanli
authors: Y
authors: Liu
mesh_terms: D000925:Anticoagulants / Q000191:economics / Q000627:therapeutic use; D002681:China; D005260:Female; D017048:Health Care Costs; D006495:Heparin, Low-Molecular-Weight / Q000191:economics / Q000627:therapeutic use; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D019934:International Normalized Ratio; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000191:economics / Q000627:therapeutic use; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000191:economics; D012189:Retrospective Studies; D000069552:Rivaroxaban; D013876:Thiophenes / Q000191:economics / Q000627:therapeutic use; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000191:economics; D014859:Warfarin / Q000191:economics / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D009025:Morpholines; D013876:Thiophenes; D014859:Warfarin; D000069552:Rivaroxaban