Inpatient Treatment Cost of Post-Stroke: An Analysis in Hospital of Occupational Diseases and Rehabilitation, Vietnam

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PCV71 Health Insurance Cost of Stroke in Hungary: A Cost of Illness Study

PCV74 Inpatient Treatment Cost of Stroke: An Analysis in Ho Chi Minh City 115 People’s Hospital, Vietnam

Oberfrank F1, Donka-Verebes É2, Boncz I3 of Experimental Medicine, Budapest, Hungary, 2Integra Consulting Zrt., Budapest, Hungary, 3University of Pécs, Pécs, Hungary

1University

1Institute

Objectives: The aim of our study is to calculate the annual health insurance treatment cost of stroke in Hungary.  Methods: The data derive from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), the only health care financing agency in Hungary. We analyzed the health insurance treatment cost and the number of patients for the year 2010. The following cost categories were included into the study: out-patient care, in-patient care, CT-MRI, PET, home care, transportation, general practitioner, drugs and medical devices. Stroke was identified with G45-46 and I60-69 codes of the International Classification of Diseases 10threvision.  Results: The Hungarian National Health Insurance Fund Administration spent 30.667 billion Hungarian Forint (HUF) (111.35 million EUR) for the treatment of stroke patients. The annual average expenditure per patient was 34869 HUF (126.6 EUR) while the average expenditure per one inhabitant was 3062 HUF (11.1 EUR). Major cost drivers were acute inpatient care (50.2 % of total health insurance costs), chronic inpatient care (9.2 %) and outpatient care (4.3%). The number of patients with stroke was 878.3 per 10000 populations. We found the highest patient number in general practitioners (879509 patients), pharmaceuticals (733965 patients) and outpatient care budget (392305 patients).  Conclusions: Stroke represents a significant burden for the health insurance system. Reimbursement of acute and chronic inpatient care are the major cost drivers for stroke in Hungary. PCV72 Economic Burden of Heart Failure in Chinese Population Huang J1, Zhang ML2, Ni Q2, Xuan JW3 1Nanjing Medical University, Nanjing, China, 2Novartis Pharmaceuticals (China), Beijing, China, 3Sun Yat-sen University, Guangzhou, China

Objectives: Heart Failure is emerging as a major public health problem in China with its rising aging population, which imposes a heavy economic burden on the population with significant healthcare costs and resource utilization. However, there has been no national data on economic burden of HF patients in China. The study aims to analyze the national medical insurance claims to evaluate HF treatment costs and healthcare resource utilization.  Methods: A retrospective study was conducted using national claim database administered by Chinese Health Insurance Research Association consisting one full-year in/outpatient claims sampled from 32 cities. Adult patients with ≥ 1 heart failure diagnosis identified by ICD10 code (I50.0, I50.1, and I50.9) or HF-specific diagnosis in Jan 2014 were selected and their claim data were retrieved from Jan-Dec 2014. Annual healthcare costs, readmission, and length of stay were calculated by patient age, city tier, and hospital level.  Results: A total of 1,157 patients met study inclusion criteria. 50.2% were women and the mean age was 70.9 (71.4% ≥  65 years). The mean annual healthcare cost per HF patient was 28,974 RMB (4,457 USD*), and increased to 30,578 RMB (4,704 USD*) in ≥ 65 age group. Hospitalization accounted for 65.6% of the total costs, whereas HF-related drug costs were only 8.2%. The mean hospital admission occurred 2.4 times per year. All-cause readmission rate was 14.8% in 30 days and up to 59.0% within a year. The mean hospital stay for HF patients was 30 days in one year; approximately > 70% of hospitalizations were due to HF.  Conclusions: The economic burden of heart failure was tremendous in terms of healthcare costs and resource utilization, and hospitalization was the major contributor to HF treatment burden. As heart failure becomes increasingly prevalent in China, it is imperative to help alleviate economic burden of HF patients with interventions targeting reducing hospitalization. *USDCNY=  6.50 PCV73 Racial Differences in Cardiovascular Disease in The United States: Healthcare Resource Utilization and Costs Udall M, McDonald M, Mardekian J Pfizer Inc, New York, NY, USA

Objectives: To understand healthcare resource utilization and costs of cardiovascular disease across racial groups in the United States (US).  Methods: We included non-Hispanic Black, Hispanic, and non-Hispanic White adults aged 20 years or older from the 2013-2014 US National Health and Nutrition Examination Survey (NHANES) in this study. Resource utilization data (i.e., physician visits, ER visits, inpatient admissions, and mental health visits) were calculated from Nationwide Inpatient Sample (NIS) 2013 and costs associated with selected cardiovascular conditions (i.e., diabetes, heart conditions, hyperlipidemia, hypertension) were assessed using the Medical Expenditure Panel Survey (MEPS) 2013.  Results: Among US adults age 20 and older, approximately 12% are Black, 16% are Hispanic, and 72% are White. Black women and Black men were most likely to visit the ER in the past year (30% and 23%, respectively). Black women were also most likely to have an inpatient admission (16%) compared with Hispanic (12%) and White women (14%). White adults were more likely to have seen a mental health professional in the last year (9%), compared with Black adults (8%) and Hispanic adults (7%). White adults were more likely to be high utilizers of doctors’ visits, with 15% having seen a doctor 10 or more times in the past year. The costliest cardiovascular conditions were diabetes mellitus, heart conditions, hyperlipidemia, and hypertension. Across the conditions and for all age groups, White adults experienced higher costs than Black and Hispanic adults. In particular, Whites aged > = 65 years had the largest expenditures for heart conditions ($42.7 million), with White males experiencing higher costs than White females.  Conclusions: Healthcare resource utilization and costs associated with cardiovascular conditions vary greatly across racial groups in the US. It is important to understand the differences between these populations in order to develop more effective healthcare interventions.

Le TN1, Nguyen TT2, Nguyen HT3, Nguyen NH3 of Medicine and Pharmacy, Ho Chi Minh City, Ho Chi Minh, Viet Nam, 2University of medicine and pharmacy, HCMC, Ho Chi Minh, Viet Nam, 3115 People’s Hospital, Ho Chi Minh City, Ho Chi Minh, Viet Nam

Objectives: Stroke is the second leading cause of death behind heart disease, accounting for 10% of total deaths worldwide. Beside disease burden, stroke is also an expensive disease. However researches focusing on stroke-related costs in Vietnam are limited. This study aims to evaluate the inpatient treatment costs of stroke and influencing factors on costs.  Methods: A cross-sectional study was conducted using a randomized sample of stroke inpatients in Ho Chi Minh City 115 People hospital. Stroke patients with full medical record and agreed to attend in the study have been chosen. Foreign patients or patients that did not finish the treatment course in research hospital or died within treatment were eliminated from this study.  Results: Study sample included 273 patients with average age at 62.97±0.87 with nearly 60% patients over 60 years old, 56.8% of men and 43.2% of women; 85% with ischemic stroke and 15% with hemorrhagic stroke; 6.17 ± 0.18 days of the length hospital stay. The average total cost per patient was VND 8,112,458.7 ± 285.499,16; in which direct cost was accounted for 77% (VND 6,307,554.5) and indirect cost was 23% (VND 1,804,904.2). In the structure of direct cost, medical cost was 1.22 times higher than non-medical cost (VND 3,470,583.8 and VND 2,836,970.7, respectively). By ingredient of medical direct cost, 60.95% of health services (VND 2,115,264.2), 21.46% of drugs (VND 744,672.1) and 17.59% of emergency services (VND 610,647.5). The influential factors on costs of stroke included age group, the length of hospital stay, the severity and the number of caregivers.  Conclusions: The medical direct cost was the majority part of total cost (42.78%) with hospital stay length of 6.17 ± 0.18 days. With the rising trend of stroke in Vietnam and the high cost burden of treatment, healthcare policies and national medical programs should be considered. PCV75 Inpatient Treatment Cost of Post-Stroke: An Analysis in Hospital of Occupational Diseases and Rehabilitation, Vietnam Nguyen TT, Le TN University of Medicine and Pharmacy, Ho Chi Minh City, Ho Chi Minh, Viet Nam

Objectives: Stroke, also known as cerebrovascular accident, is the second leading cause of death worldwide with 10% of all deaths. The impact of post-stroke on patient is huge not only because of the disease burden but also the medical cost of supportive care. The aim of this study is to evaluate the inpatient care costs of post-stroke in Vietnam based on the data from hosspital of rehabilitation and occupational diseases.  Methods: A retrospective study with database of all patients hospitalized for post-store care with ICD codes I60-I64 that discharged from hospital within 2015. Patients who did not finish the treatment course in research hospital or died within treatment were eliminated from this study. Only medical direct cost has been evaluated.  Results: Study sample included 163 patients from hospital database in 2015 with the average age at 65.23±1.19; 63% male; length of hospital stay of 22.65 ± 1.18 days; 69.8% of patients with ischemic stroke and 30.2% with hemorrhagic stroke. The average total post-stroke treatment cost per patient accounted for VND 3,294,046.8 ± 217,354.2; 68.6% of which was covered by health insurance organizations (VND 2,259,681.1) and 31.4% was covered by patients (VND 1,034,364.8). In the structure of cost, the costs of health services were nearly 2 times higher than drug costs (VND 2,191,867.5 vs VND 1,102,179.1; respectively). The length of hospital stay was the main influential factor on costs of post-stroke care.  Conclusions: With hospital stay length of 22.65 ± 1.18 days, the average total cost of post-stroke treatment was VND 3,294,046.8 ± 217,354.2 per patient with the majority part of health services and more than 30% of total costs was paid by patients. More healthcare policies and national medical programs should be considered to reduce the cost burden for stroke patients. PCV76 Cost of Treatment Hypertention Inpatients in Vietnam Nguyen TT1, Nguyen TV2, Vu TT2, Nguyen HN3 of medicine and pharmacy, Ho Chi Minh City, Ho Chi Minh City, Viet Nam, 2University of Medicine and Pharmacy, Ho Chi Minh City, Ho CHi Minh, Viet Nam, 3General Hospital of Tran Van Thoi Region, Ho CHi Minh, Viet Nam

1University

Objectives: Hypertention is a common non-communicable diseases in both male and female populations, 1 out of every 3 adults have high blood pressure. Reseaches in treatment cost of hypertension in Vietnam were limited. Therefore, the aim of this study was evaluate the treatment cost of patients with hypertension.  Methods: A cross-sectional study was conducted with database of all patients hospitalized for hypertension at Tran Van Thoi hospital within 2014 and 2015. Patients who did not finish the treatment course in research hospital or died within treatment were eliminated from this study. The medical direct cost was evaluated in this study.  Results: Data from 1939 patients with nearly 70% female, 72.1% over 60 years old; in 85.7% with health insurance, 26% patiens with cardiovascular diseases and  72% having other disease except hypertension was analysed. With average hospital stay length of 6 days, the average total cost per patient was 755.48±12.55 thousand VND, including 76% covered by health insurance and 24% covered by patients. In the stucture of total cost, cost for preclinical tests, medications and hospital beds were 312,8±2,1; 202,6 ± 9,2 and 148,1±1,9 thousand VND, respectively. The influencing factors on the total treatment cost include gender (p= 0.001); occupation (p= 0.008). The total treatment cost of male was higher than those of female (827.7 and 723.7 thousand VND, p= 0.001). There was a statistical significant difference between total treatment cost of farmers and retired patients (680.8; 782.2 thousand VND and p =  0.009).  Conclusions: The total treatment cost was 755.48±12.55 thousand VND with majority part for preclinical test. The main factors affecting the total cost of hypertention inpatients include gender, occupation.