Zhonghua Nan Ke Xue. 2024 Nov;30(11):987-993.
ABSTRACT
OBJECTIVE: To investigate the factors influencing the hospitalization expenses of PCa patients and provide some evidence for effectively reducing the direct economic burden of disease caused by laparoscopic radical prostatectomy (LRP).
METHODS: The author obtained the hospitalization data on 893 cases of PCa treated by LRP in a top tertiary hospital in Wuhan between January 1, 2019 and June 30, 2024. A database was constructed using the Stata 18.0 software, the Mann-Whitney U and Kruskal-Wallis H tests performed using the SPSS 27.0 and R 4.4.1 softwares, and the influencing factors for the hospitalization expenses of the patients analyzed by multiple linear regression, quantile regression, and random forest algorithm.
RESULTS: Out-of-pocket payment accounted for 64.40% of the total hospitalization costs, averaging ￥60 794.9, with the per capita treatment cost (￥20 631.6), drug cost (￥15 046.2) and consumable cost (￥12 469.6) as the top 3 items of expenditure, accounting for 33.94%, 24.75% and 20.51%, respectively. The results of multiple linear regression analysis showed that the number of hospital days (β = 0.027), the number of comorbidities (β = 0.008), the mode of admission (with the outpatient department as reference, the emergency department ［β = 0.128］ and transfer from other institutions ［β = 0.251］), and the mode of surgery (with LRP ［β = 0.157］ as reference) all had statistically significant impacts on the sub-per capita hospitalization costs (P < 0.05). Quantile regression analysis revealed dramatic influence of the number of hospital days and surgical mode in different quantiles (P < 0.001), and random forest regression analysis showed the two influencing factors ranking the top two in terms of importance.
CONCLUSION: PCa patients bear a heavy burden of hospitalization costs. The composition of the costs needs to be optimized, and efforts should be made to reduce the hospitalization expenses of the PCa patients by promoting the inclusion of medical consumables in medical insurance, facilitating the development of drugs and domestication of surgical robots, and reasonably shortening the hospital stay of the patients.
PMID:40783867
