In-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrial fibrillation

Objective: Limited data are available on the direct costs of hospitalization owing to thromboembolism and bleeding in patients with atrial fibrillation (AF) in China. Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic strategies. This...

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Autores principales:	San-Shuai Chang, Jia-Hui Wu, Yi Liu, Ting Zhang, Xin Du, Jian-Zeng Dong, Gregory Y.H. Lip, Chang-Sheng Ma
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2018
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/bd598a7fdb194862b55789668082d728
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spelling	oai:doaj.org-article:bd598a7fdb194862b55789668082d7282021-12-02T13:37:39ZIn-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrial fibrillation2095-882X10.1016/j.cdtm.2018.01.001https://doaj.org/article/bd598a7fdb194862b55789668082d7282018-06-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095882X17300749https://doaj.org/toc/2095-882XObjective: Limited data are available on the direct costs of hospitalization owing to thromboembolism and bleeding in patients with atrial fibrillation (AF) in China. Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic strategies. This study aimed to provide detailed data regarding in-hospital direct costs for these patients, compare the costs at different scenarios, and identify independent factors that may predict the costs. Methods: We collected data regarding in-hospital direct costs among patients with AF who were hospitalized owing to ischemic stroke (IS), transient ischemic attack (TIA), intracranial hemorrhage (ICH), or major gastrointestinal bleeding. All data were collected from 7 representative tertiary referral hospitals and 3 secondary care hospitals from December 2009 to October 2014. Results: In total, 312 eligible patients with thromboembolism and 143 patients with major bleeding were identified, and their hospital charts were reviewed. The median in-hospital direct costs were 17,857 Chinese Yuan (CNY) for IS and 16,589 CNY for TIA (equivalent to 2907 US dollars and 2701 US dollars, respectively). For patients with major bleeding, the costs were 27,924 CNY for ICH and 18,196 CNY for major gastrointestinal bleeding (equivalent to 4546 US dollars and 2962 US dollars, respectively). The direct costs were mainly driven by medications, which accounted for approximately 33.4%–36.1% in different groups of patients. The direct costs were highly related to the hospital level and National Institutes of Health Stroke Scale scores in patients with thromboembolism; in patients with ICH, the factors included hospital level, warfarin treatment before admission, and prior hospitalization for stroke. Conclusions: Given the high prevalence, AF-related thromboembolism and bleeding impose considerable economic burden on the Chinese society. Efforts to improve the management of AF may confer substantial economic benefits. Keywords: Atrial fibrillation, Ischemic stroke, Bleeding, In-hospital direct costsSan-Shuai ChangJia-Hui WuYi LiuTing ZhangXin DuJian-Zeng DongGregory Y.H. LipChang-Sheng MaKeAi Communications Co., Ltd.articleMedicine (General)R5-920ENChronic Diseases and Translational Medicine, Vol 4, Iss 2, Pp 127-134 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 San-Shuai Chang Jia-Hui Wu Yi Liu Ting Zhang Xin Du Jian-Zeng Dong Gregory Y.H. Lip Chang-Sheng Ma In-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrial fibrillation
description	Objective: Limited data are available on the direct costs of hospitalization owing to thromboembolism and bleeding in patients with atrial fibrillation (AF) in China. Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic strategies. This study aimed to provide detailed data regarding in-hospital direct costs for these patients, compare the costs at different scenarios, and identify independent factors that may predict the costs. Methods: We collected data regarding in-hospital direct costs among patients with AF who were hospitalized owing to ischemic stroke (IS), transient ischemic attack (TIA), intracranial hemorrhage (ICH), or major gastrointestinal bleeding. All data were collected from 7 representative tertiary referral hospitals and 3 secondary care hospitals from December 2009 to October 2014. Results: In total, 312 eligible patients with thromboembolism and 143 patients with major bleeding were identified, and their hospital charts were reviewed. The median in-hospital direct costs were 17,857 Chinese Yuan (CNY) for IS and 16,589 CNY for TIA (equivalent to 2907 US dollars and 2701 US dollars, respectively). For patients with major bleeding, the costs were 27,924 CNY for ICH and 18,196 CNY for major gastrointestinal bleeding (equivalent to 4546 US dollars and 2962 US dollars, respectively). The direct costs were mainly driven by medications, which accounted for approximately 33.4%–36.1% in different groups of patients. The direct costs were highly related to the hospital level and National Institutes of Health Stroke Scale scores in patients with thromboembolism; in patients with ICH, the factors included hospital level, warfarin treatment before admission, and prior hospitalization for stroke. Conclusions: Given the high prevalence, AF-related thromboembolism and bleeding impose considerable economic burden on the Chinese society. Efforts to improve the management of AF may confer substantial economic benefits. Keywords: Atrial fibrillation, Ischemic stroke, Bleeding, In-hospital direct costs
format	article
author	San-Shuai Chang Jia-Hui Wu Yi Liu Ting Zhang Xin Du Jian-Zeng Dong Gregory Y.H. Lip Chang-Sheng Ma
author_facet	San-Shuai Chang Jia-Hui Wu Yi Liu Ting Zhang Xin Du Jian-Zeng Dong Gregory Y.H. Lip Chang-Sheng Ma
author_sort	San-Shuai Chang
title	In-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrial fibrillation
title_short	In-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrial fibrillation
title_full	In-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrial fibrillation
title_fullStr	In-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrial fibrillation
title_full_unstemmed	In-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrial fibrillation
title_sort	in-hospital direct costs for thromboembolism and bleeding in chinese patients with atrial fibrillation
publisher	KeAi Communications Co., Ltd.
publishDate	2018
url	https://doaj.org/article/bd598a7fdb194862b55789668082d728
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In-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrial fibrillation

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