Inpatient expenses of pneumoconiosis patients in four types of medical institutions and its influencing factors

Background Domestic research on the economic burden of pneumoconiosis has been reported, but most of them are based on one enterprise or medical institution, and national and regional survey data are scarce.

Objective This study analyzes the inpatient medical expenses of pneumoconiosis patients in different types of medical institutions in a province of China, aiming to provide insights for relevant government departments to formulate management measures of pneumoconiosis treatment and relief expenses and to reduce the economic burden of pneumoconiosis.

Methods Four medical institutions of different types in a province in 2019 were selected to investigate inpatient medical expenses of 446 male pneumoconiosis patients using the data from medical records. Kruskal-Wallis H test was used to analyze the differences of total expenses, average daily expenses, treatment and nursing care expenses, examination and laboratory fees, drug cost, and other cost among the patients in different categories of medical institution, age, education level, employment type, disease, comorbidity, and payment method. Multiple stepwise regression models were used to analyze the influences of employment type, age, educational level, comorbidity, disease, and payment method on total expenses and average daily expenses.

Results There were significant differences in the total expenses (15 183.94, 8367.65, 15325.82, and 8137.48 yuan), average daily expenses (377.28, 283.89, 541.85, and 168.47 yuan), treatment and nursing care expenses (5668.50, 6040.10, 2994.00, and 1517.00 yuan), examination and laboratory fees (1 953.00, 845.55, 1542.90, and 617.00 yuan), and drug cost (6 780.59, 1431.52, 10798.50, and 3209.80 yuan) among the four medical institutions, namely, corporate class A hospital, corporate occupational disease hospital, provincial occupational disease hospital, and municipal occupational disease hospital (P < 0.01). The results of Kruskal-Wallis H test showed that there were significant differences in total expenses, average daily expenses, treatment and nursing care expenses, examination and laboratory fees, drug cost, and other cost among different age, education level, employment type, disease, comorbidity, and payment method groups (P < 0.05). The multiple stepwise regression analysis results showed that comorbidity, employment type, disease, age, and payment method were the influencing factors of total expenses (P < 0.05), and comorbidity had the greatest influence (R²=0.065, b=-0.262). Employment type, age, comorbidity, education level, payment method, and disease were the influencing factors of average daily expenses (P < 0.05), and employment type had the greatest influence (R²=0.226, b=0.614).

Conclusion Different types of medical institutions show varied medical costs in the treatment of pneumoconiosis, which are mainly related to employment type, age, comorbidity, education level, payment methods, and disease.