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Medical costs and hospital utilization for hemophilia A and B urban inpatients in China: a national cross-sectional study.

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机构： [1]School of Management, Beijing University of Chinese Medicine, Beijing,China [2]Australian National Institute of Management and Commerce, EveleighSydney, NSW, Australia [3]School of Economics and School of Management,Tianjin Normal University, Tianjin, China [4]Guangdong Institute for InternationalStrategies, Guangdong University of Foreign Studies, Guangzhou, China [5]Newcastle Business School, University of Newcastle, Newcastle, Callaghan,Australia [6]Medical Device Regulatory Research and Evaluation Centre, WestChina Hospital, Sichuan University, Chengdu, China [7]School of Management,University of Liverpool, Chatham Building, Chatham Street, L697ZH Liverpool,England [8]National Institute of Healthcare Security, Capital Medical University,Beijing, China

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关键词： Hemophilia Medical cost Hospital utilization Urban China

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Hemophilia care in mainland China has been greatly improved since the establishment of the Hemophilia Treatment Center Collaborative Network of China (HTCCNC), and most of drugs for hemophilia have been covered by basic medical insurance schemes. This study assesses whether medical costs and hospital utilization disparities exist between hemophilia A and hemophilia B urban inpatients in China and, second, whether the prescription of coagulation factor concentrates for hemophilia A and hemophilia B inpatients was optimal, from the third payer perspective.We conducted a retrospective nationwide analysis based on a 5% random sample from claims data of China Urban Employees' Basic Medical Insurance (UEBMI) and Urban Residents' Basic Medical Insurance (URBMI) schemes from 2010 to 2016. Univariate analysis and multiple regression analysis based on a generalized linear model were conducted.A total of 487 urban inpatients who had hemophilia were identified, including 407 inpatients with hemophilia A and 80 inpatients with hemophilia B. Total medical cost for hemophilia B inpatients was significantly higher than for hemophilia A inpatients (USD 2912.81 versus USD 1225.60, P < 0.05), and hemophilia B inpatients had a significantly longer length of hospital stay than hemophilia A inpatients (9.00 versus 7.00, P < 0.05). Total medical costs were mostly allocated to coagulation factor products (76.86-86.68%), with coagulation factor cost of hemophilia B significantly higher than hemophilia A (P < 0.05). Both hemophilia cohorts utilized greatest amount of plasma-derived Factor VIII, followed by recombinant Factor VIII and prothrombin complex concentrates.Patients with hemophilia B experienced significantly higher inpatient cost, coagulation factor cost and longer length of hospital stay than patients with hemophilia A. Our findings revealed the suboptimal use of coagulation factor concentrate drugs and a higher drug cost burden incurred by hemophilia B than hemophilia A inpatients. Our results call for efforts to strengthen drug regulatory management for hemophilia and to optimize medical insurance schemes according to hemophilia types.© 2022. The Author(s).

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出版当年[2021]版：

大类 | 3 区医学

小类 | 3 区卫生保健与服务

最新[2025]版：

大类 | 2 区医学

小类 | 3 区卫生保健与服务

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第一作者机构： [1]School of Management, Beijing University of Chinese Medicine, Beijing,China

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