The costs of inappropriate referral pathways in inpatient care for three major noncommunicable diseases in Mongolia: a national registry-based analysis
Abstract Background Non-communicable diseases (NCDs) consistently pose a huge economic burden to health systems and countries in general. The aim of this study was to quantify inpatient costs associated with chronic obstructive pulmonary disease, stroke and ischemic heart disease stratified by type...
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oai:doaj.org-article:ce7ccc8a2bb94e06a0683c0465649f342021-11-28T12:07:48ZThe costs of inappropriate referral pathways in inpatient care for three major noncommunicable diseases in Mongolia: a national registry-based analysis10.1186/s12913-021-07281-81472-6963https://doaj.org/article/ce7ccc8a2bb94e06a0683c0465649f342021-11-01T00:00:00Zhttps://doi.org/10.1186/s12913-021-07281-8https://doaj.org/toc/1472-6963Abstract Background Non-communicable diseases (NCDs) consistently pose a huge economic burden to health systems and countries in general. The aim of this study was to quantify inpatient costs associated with chronic obstructive pulmonary disease, stroke and ischemic heart disease stratified by type of referral pathway, and to investigate key factors that drive these costs. Methods A registry-based data analysis was performed using national public hospital inpatient records from 2016 to 2018 for 117,600 unique patients and linking patient-level inpatient health care use with hospital-specific unit cost per bed-day. These were combined to calculate the annual inpatient costs for each of the three disorders per person and per year. Generalized linear modeling was used to assess the association of inpatient costs with age, gender, location, comorbidity, treatment referral pathways and years. Results Across three diagnoses, the majority of patients were female. Most were over 50–60 years old, with more than half being a pensioner, typically with at least one comorbidity. About 25% of patients followed what might be considered inappropriate (unofficial) inpatient referral pathways. Mean annual inpatient costs were int$ 721. These costs rose to int$ 849 for unofficial pathways and dropped to int$677 for official pathways. Further covariates significantly associated with high inpatient costs were location, age, gender, and comorbidity. Conclusion Our findings provide background information essential to develop evidence-based and cost-effective interventions aimed at health promotion, prevention and service delivery. Reducing the unofficial use of inpatient care can improve efficient resource allocation in health care and prevent further escalation of inpatient costs in the future.Ariuntuya TuvdendorjOtgonjargal DechinkhorlooBayarsaikhan DorjsurenErik BuskensTalitha FeenstraBMCarticlePublic aspects of medicineRA1-1270ENBMC Health Services Research, Vol 21, Iss 1, Pp 1-10 (2021) |
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DOAJ |
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DOAJ |
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EN |
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Public aspects of medicine RA1-1270 |
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Public aspects of medicine RA1-1270 Ariuntuya Tuvdendorj Otgonjargal Dechinkhorloo Bayarsaikhan Dorjsuren Erik Buskens Talitha Feenstra The costs of inappropriate referral pathways in inpatient care for three major noncommunicable diseases in Mongolia: a national registry-based analysis |
| description |
Abstract Background Non-communicable diseases (NCDs) consistently pose a huge economic burden to health systems and countries in general. The aim of this study was to quantify inpatient costs associated with chronic obstructive pulmonary disease, stroke and ischemic heart disease stratified by type of referral pathway, and to investigate key factors that drive these costs. Methods A registry-based data analysis was performed using national public hospital inpatient records from 2016 to 2018 for 117,600 unique patients and linking patient-level inpatient health care use with hospital-specific unit cost per bed-day. These were combined to calculate the annual inpatient costs for each of the three disorders per person and per year. Generalized linear modeling was used to assess the association of inpatient costs with age, gender, location, comorbidity, treatment referral pathways and years. Results Across three diagnoses, the majority of patients were female. Most were over 50–60 years old, with more than half being a pensioner, typically with at least one comorbidity. About 25% of patients followed what might be considered inappropriate (unofficial) inpatient referral pathways. Mean annual inpatient costs were int$ 721. These costs rose to int$ 849 for unofficial pathways and dropped to int$677 for official pathways. Further covariates significantly associated with high inpatient costs were location, age, gender, and comorbidity. Conclusion Our findings provide background information essential to develop evidence-based and cost-effective interventions aimed at health promotion, prevention and service delivery. Reducing the unofficial use of inpatient care can improve efficient resource allocation in health care and prevent further escalation of inpatient costs in the future. |
| format |
article |
| author |
Ariuntuya Tuvdendorj Otgonjargal Dechinkhorloo Bayarsaikhan Dorjsuren Erik Buskens Talitha Feenstra |
| author_facet |
Ariuntuya Tuvdendorj Otgonjargal Dechinkhorloo Bayarsaikhan Dorjsuren Erik Buskens Talitha Feenstra |
| author_sort |
Ariuntuya Tuvdendorj |
| title |
The costs of inappropriate referral pathways in inpatient care for three major noncommunicable diseases in Mongolia: a national registry-based analysis |
| title_short |
The costs of inappropriate referral pathways in inpatient care for three major noncommunicable diseases in Mongolia: a national registry-based analysis |
| title_full |
The costs of inappropriate referral pathways in inpatient care for three major noncommunicable diseases in Mongolia: a national registry-based analysis |
| title_fullStr |
The costs of inappropriate referral pathways in inpatient care for three major noncommunicable diseases in Mongolia: a national registry-based analysis |
| title_full_unstemmed |
The costs of inappropriate referral pathways in inpatient care for three major noncommunicable diseases in Mongolia: a national registry-based analysis |
| title_sort |
costs of inappropriate referral pathways in inpatient care for three major noncommunicable diseases in mongolia: a national registry-based analysis |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/ce7ccc8a2bb94e06a0683c0465649f34 |
| work_keys_str_mv |
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