Characterizing Potentially Preventable Hospitalizations of High-Cost Patients in Rural China

Frontiers in Public Health

Niek S. Klazinga¹  Dionne S. Kringos¹  Shan Lu²  Yan Zhang²  Liang Zhang⁴ 

[1] Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam University Medical Centers, Amsterdam, Netherlands;Research Centre for Rural Health Service, Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, China;School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;School of Political Science and Public Administration, Wuhan University, Wuhan, China;

关键词: high-cost patients;    potentially preventable hospitalization;    ambulatory care sensitive conditions;    preventable inpatient cost;    rural China;   

DOI  :  10.3389/fpubh.2022.804734

来源: DOAJ

【 摘 要 】

IntroductionHigh-cost patients are characterized by repeated hospitalizations, and inpatient cost accounts for a large proportion of their total health care spending. This study aimed to assess the occurrence and costs of potentially preventable hospitalizations and explore contributing factors among high-cost patients in rural China.MethodsWe examined a population-based sample of patients using the 2016 New Rural Cooperative Medical Scheme in Dangyang city, China. Eighteen thousand forty-three high-cost patients were identified. A validated tool and logistic regression analysis were used to determine preventable hospitalizations and their patient-level and supply-side factors.ResultsHigh-cost patients were older (average age of 54 years) than non-high-cost patients (50 years) and more likely to come from poverty-stricken families. The occurrence of preventable hospitalization was 21.65% among high-cost patients. The proportion of preventable inpatient cost in total inpatient and outpatient expenditure among high-cost patients (5.81%) was lower than that of non-high-cost patients (7.88%) but accounted for 75.87% of the overall preventable inpatient cost. High-cost patients with more hospitalizations were more likely to experience preventable hospitalization, and those with heart failure, COPD, diabetes and mixed conditions were at a higher risk of preventable hospitalization, while those with more outpatient visits were less likely to show preventable hospitalization.ConclusionsThe occurrence of preventable hospitalization among high-cost patients in rural China was sizeable. The preventable inpatient cost of the overall population was concentrated among high-cost patients. Interventions such as improving preventive care and disease management targeting high-cost patients within counties may improve patients' health outcomes and quality of life and reduce overall preventable inpatient cost.

【 授权许可】

Unknown