Analysis of hospitalization costs and influencing factors for gouty arthritis patients at a tertiary hospital in Haikou, Hainan province
10.3760/cma.j.cn141217-20240610-00186
- VernacularTitle:海口市某三甲医院痛风性关节炎患者住院费用及其影响因素分析
- Author:
Huina ZHUANG
1
;
Juan LI
Author Information
1. 海南医科大学第一临床医学院，海口 571189
- Publication Type:Journal Article
- Keywords:
Gout;
Comorbidities;
Hospitalization expenses;
Hospitalization causes
- From:
Chinese Journal of Rheumatology
2025;29(4):307-311
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the primary causes of hospitalization, comorbidities, hospitalization costs, and the factors influencing hospitalization expenses in gouty arthritis patients at a tertiary hospital in Haikou, Hainan Province, with the aim of providing a theoretical basis for optimizing medical resource allocation.Methods:We collected hospitalization data from gouty arthritis patients diagnosed between January and December 2021 at a tertiary hospital in Haikou. The main causes of hospitalization, the types and proportions of comorbidities, and their associations with hospitalization costs were analyzed. Patients were categorized into groups based on the primary cause of hospitalization: non-surgical gout, surgery for gout tophiformation, cardiovascular disease, cerebrovascular disease, renal disease, digestive system disease, and type 2 diabetes with complications. Chi-square tests were used for categorical variables, one-way ANOVA or Mann-Whitney U test for continuous variables, and multivariate linear regression for identifying factors influencing hospitalization costs. Spearman′s correlation analysis was conducted to explore associations between variables. Results:A total of 851 patients were included, with 721 males (84.7%) and 130 females (15.3%). The mean age was (65.3±14.1) years, and the average length of stay was (11.5±8.5)days. Among the 833 patients with comorbidities (97.9%), the most prevalent comorbid conditions were hypertension (539 cases, 63.3%), cerebral infarction (378 cases, 44.4%), and type 2 diabetes along with its complications (346 cases, 40.7%). The total cost for the non-surgical gout tophi group was 1.01 (0.72, 1.26) ten thousand yuan, which was significantly lower than that for the gout tophi surgery group [2.04(1.37, 3.42)ten thousand yuan( Z=-4.94, P<0.001)], the cardiovascular disease group [1.30(0.71, 2.29) ten thousand yuan( Z=-4.31, P<0.001)], and the cerebrovascular disease group [1.29(0.98, 2.07) ten thousand yuan, Z=-4.68, P<0.001)]. The total cost for the gout tophi surgery group was 2.04 (1.37, 3.42) ten thousand yuan, which was significantly higher than that for the non-surgical gout tophi group [1.01(0.72, 1.26) ten thousand yuan, Z=-4.94, P<0.001)], the cardiovascular disease group [1.30(0.71, 2.29) ten thousand yuan, Z=-2.40, P=0.020)], the cerebrovascular disease group [1.29(0.98, 2.07) ten thousand yuan, Z=-2.50, P=0.010)], the digestive system disease group [1.04(0.67, 1.97) ten thousand yuan, Z=-2.73, P=0.010)], the renal system disease group [1.01(0.78, 1.53)ten thousand yuan, Z=-3.62, P<0.001)], and the type 2 diabetes and its complications group [(0.88(0.67, 1.25) ten thousand yuan, Z=-4.13, P<0.001)]. Spearman correlation analysis showed a strong positive correlation between length of hospital stay and total hospitalization cost ( r=0.71, P<0.001), as well as a strong positive correlation between total cost and insurance reimbursement ( r=0.87 , P<0.001). The results from multiple linear regression analysis indicated that the length of hospital stay ( B=2 670.36, P<0.001), cardiovascular diseases ( B=12 266.28, P<0.001), digestive system diseases ( B=11 251.76, P=0.001), and cerebrovascular diseases ( B=7 318.79, P=0.020) were significantly positively associated with hospitalization costs. Conclusion:Tophus surgery incurred the highest hospitalization costs, with cardiovascular and cerebrovascular diseases being the primary reasons for gout-related hospitalizations. Standardizing gout treatment may reduce the disease burden by potentially lowering the incidence of comorbidities.
