BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),formally known as nonalcoholic fatty liver disease,is the most common chronic liver disease in the United States.Patients with MASLD have been...BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),formally known as nonalcoholic fatty liver disease,is the most common chronic liver disease in the United States.Patients with MASLD have been reported to be at a higher risk of developing severe coronavirus disease 2019(COVID-19)and death.However,most studies are single-center studies,and nationwide data in the AIM To study the influence of MASLD on COVID-19 hospitalizations during the initial phase of the pandemic.METHODS We retrospectively analyzed the 2020 National Inpatient Sample(NIS)database to identify primary COVID-19 hospitalizations based on an underlying diagnosis of MASLD.A matched comparison cohort of COVID-19 hospit-alizations without MASLD was identified from NIS after 1:N propensity score matching based on gender,race,and comorbidities,including hypertension,heart failure,diabetes,and cirrhosis.The primary outcomes included inpatient mortality,length of stay,and hospitalization costs.Secondary outcomes included the prevalence of systemic complications.RESULTS A total of 2210 hospitalizations with MASLD were matched to 2210 hospitalizations without MASLD,with a good comorbidity balance.Overall,there was a higher prevalence of severe disease with more intensive care unit admissions(9.5%vs 7.2%,P=0.007),mechanical ventilation(7.2%vs 5.7%,P=0.03),and septic shock(5.2%vs 2.7%,P<0.001)in the MASLD cohort than in the non-MASLD cohort.However,there was no difference in mortality(8.6%vs 10%,P=0.49),length of stay(5 d vs 5 d,P=0.25),and hospitalization costs(42081.5$vs 38614$,P=0.15)between the MASLD and non-MASLD cohorts.CONCLUSION The presence of MAFLD with or without liver cirrhosis was not associated with increased mortality in COVID-19 hospitalizations;however,there was an increased incidence of severe COVID-19 infection.This data(2020)predates the availability of COVID-19 vaccines,and many MASLD patients have since been vaccinated.It will be interesting to see if these trends are present in the subsequent years of the pandemic.展开更多
Introduction: In this paper we investigate the possible connection between socioeconomic status as demarcated by employment and in-surance status and consumption of healthcare resources in spine surgery patients. Meth...Introduction: In this paper we investigate the possible connection between socioeconomic status as demarcated by employment and in-surance status and consumption of healthcare resources in spine surgery patients. Methods: The clinical records of 1599 spine surgery pa-tients counted from 2008-2009 were reviewed. The largest groups of patients belonged to MS-DRG 460 (N = 585) and to MS-DRG 473 (N = 700). These two MS-DRG patient groups were used as the study cohort representing patients who, by definition, did not have serious comor-bidities or complications. Results: Unemployed non-cervical patients tended to stay on average 1.8 days longer in hospital and had on average $5800 higher hospital charges. No major differ-ences were noted in length of stay and hospital cost between government and private insurance patients. However, self-pay non-cervical fusion patients had notable increases in length of stay and hospital cost, especially in the >39 and <60 age group with the difference in length of stay amounting to 5 days and in hospital charges to $10,000. Univariate analysis with DRG (460 or 473) as a covariate showed significant impact from employment status on length of stay (F = 4.259, P = 0.014) and less significant impact from payor category on hospital charges (F = 2.229, P = 0.064) in the economically-productive 40 -59 age group. Conclusions: In general, no increase in hospital resource consumption was noted except among self-pay patients, the same group seemingly least able to afford expensive healthcare.展开更多
Objective The evaluation index of medical equipment's economic benefit is based on the usage of medical equipment,the traditional data collection method is time-consuming,laborious and not entirely accurate.The us...Objective The evaluation index of medical equipment's economic benefit is based on the usage of medical equipment,the traditional data collection method is time-consuming,laborious and not entirely accurate.The usage of medical equipment is obtained by designing data query statements from the HIS system.Methods First the charging items are in correspondence with the device's name included,second fees and other relevant data are extracted from charging module in HIS.Through a rough estimate of the recovery period and an increase or decrease ratio,the economic benefit of the medical equipment can be analyzed.Results Through the method of the benefit analysis of the medical equipment,we can clearly find out the different economic benefit of the equipment,and finally analyze the reasons.Conclusion Practice has proved that,this methad,it can greatly reduce human,material resources required in data collection and improve the accuracy of the data.It can help hospital managers timely to grasp the operating costs of medical equipment and other information,and also provide scientific data for hospital managers when they purchase reasonable medical equipment.展开更多
Introduction: As the U.S. population undergoes continuous shifts the population’s health profile changes dynamically resulting in more or less expression of certain psychiatric disorders and utilization of health-car...Introduction: As the U.S. population undergoes continuous shifts the population’s health profile changes dynamically resulting in more or less expression of certain psychiatric disorders and utilization of health-care resources. In this paper, we analyze national data on the psychiatric morbidity of American patients and their summated cost in different age groups. Methods: The latest data (2009) on the number of hospital discharges and national bill (hospital charges) linked with psychiatric disorders were extracted from the Nationwide Inpatient Sample (NIS). Results: National data shows that mood disorders are the largest diagnostic category in terms of percentage of psychiatri-crelated discharges in the 1 - 17 years age group. The proportion decreases gradually as age progresses while delirium, dementia, amnestic and other cognitive disorders increase exponentially after 65 years of age. Schizophrenia and other psychotic disorders as well as alcohol and substance-related disorders peak in the working age groups (18 - 64 years). From an economic point of view, mood disorders in the 18 - 44 age group has the highest national bill ($5.477 billion) followed by schizophrenic and other psychotic disorders in the same age group ($4.337 billion) and mood disorders in the 45 - 64 age group ($4.310 billion). On the third place come schizophrenic and other psychotic disorders in the 45 - 64 age group ($3.931 billion). Conclusion: This paper illustrates the high cost of psychiatric care in the U.S., especially the large fraction of healthcare money spent on working-age patients suffering from mood disorders. This underlines psychiatric cost-efficiency as a vital topic in the current healthcare debate.展开更多
Background Congenital heart disease(CHD)is the most common congenital anomaly affecting 1.35 million newborns globally every year.Children affected by CHD would normally come across growth failure at a young age.As co...Background Congenital heart disease(CHD)is the most common congenital anomaly affecting 1.35 million newborns globally every year.Children affected by CHD would normally come across growth failure at a young age.As complex CHD has a high mortality rate,it needs to be corrected as soon as possible after birth.Methods The medical records of infants with diagnosed CHD according to International Classification of Diseases(ICD)10 th Revision codes(January 2009-June 2017)who underwent cardiac surgery were reviewed.In the 431 patients who met the study criteria,their clinical characteristics,outcomes and cost data were collected.Linear regression models were used to determine the hospitalization cost after adjustment for demographic and other risk factors.Results For the 431 patients who met the study criteria,the median hospital stay was 24 days(range 17~34 days),which was not significantly changed over 9 years.The median inflation-adjusted total hospital cost was ￥80634(range ￥ 64585~97831),which was on the increase.The predominant influential factors of hospitalization expenses were hospitalization days,hospitalization deaths,European surgical scores,postsurgical complications and preoperative ventilator assistance.The least amount of hospitalization expenses was spent when hospitalization stay≤10 days and ARISTOTLE surgery total score≤12.25.Hospitalization expenses were related to hospitalization days when it was 10 days to 24 days.The expenses of deaths were higher than the survivors when hospitalization stay was 25 days to 48 days,the number of postsurgical complications≥1.The expenses of deaths reached the highest when the hospital stay≥49 days with the number of postsurgical complications≥3.Conclusion The hospitalization expense of neonate’s CHD has been increasing in recent years.Different hospitalization stays and surgical procedure difficulties,postsurgical complications and hospital deaths could affect the total cost of hospitalization.展开更多
文摘BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),formally known as nonalcoholic fatty liver disease,is the most common chronic liver disease in the United States.Patients with MASLD have been reported to be at a higher risk of developing severe coronavirus disease 2019(COVID-19)and death.However,most studies are single-center studies,and nationwide data in the AIM To study the influence of MASLD on COVID-19 hospitalizations during the initial phase of the pandemic.METHODS We retrospectively analyzed the 2020 National Inpatient Sample(NIS)database to identify primary COVID-19 hospitalizations based on an underlying diagnosis of MASLD.A matched comparison cohort of COVID-19 hospit-alizations without MASLD was identified from NIS after 1:N propensity score matching based on gender,race,and comorbidities,including hypertension,heart failure,diabetes,and cirrhosis.The primary outcomes included inpatient mortality,length of stay,and hospitalization costs.Secondary outcomes included the prevalence of systemic complications.RESULTS A total of 2210 hospitalizations with MASLD were matched to 2210 hospitalizations without MASLD,with a good comorbidity balance.Overall,there was a higher prevalence of severe disease with more intensive care unit admissions(9.5%vs 7.2%,P=0.007),mechanical ventilation(7.2%vs 5.7%,P=0.03),and septic shock(5.2%vs 2.7%,P<0.001)in the MASLD cohort than in the non-MASLD cohort.However,there was no difference in mortality(8.6%vs 10%,P=0.49),length of stay(5 d vs 5 d,P=0.25),and hospitalization costs(42081.5$vs 38614$,P=0.15)between the MASLD and non-MASLD cohorts.CONCLUSION The presence of MAFLD with or without liver cirrhosis was not associated with increased mortality in COVID-19 hospitalizations;however,there was an increased incidence of severe COVID-19 infection.This data(2020)predates the availability of COVID-19 vaccines,and many MASLD patients have since been vaccinated.It will be interesting to see if these trends are present in the subsequent years of the pandemic.
文摘Introduction: In this paper we investigate the possible connection between socioeconomic status as demarcated by employment and in-surance status and consumption of healthcare resources in spine surgery patients. Methods: The clinical records of 1599 spine surgery pa-tients counted from 2008-2009 were reviewed. The largest groups of patients belonged to MS-DRG 460 (N = 585) and to MS-DRG 473 (N = 700). These two MS-DRG patient groups were used as the study cohort representing patients who, by definition, did not have serious comor-bidities or complications. Results: Unemployed non-cervical patients tended to stay on average 1.8 days longer in hospital and had on average $5800 higher hospital charges. No major differ-ences were noted in length of stay and hospital cost between government and private insurance patients. However, self-pay non-cervical fusion patients had notable increases in length of stay and hospital cost, especially in the >39 and <60 age group with the difference in length of stay amounting to 5 days and in hospital charges to $10,000. Univariate analysis with DRG (460 or 473) as a covariate showed significant impact from employment status on length of stay (F = 4.259, P = 0.014) and less significant impact from payor category on hospital charges (F = 2.229, P = 0.064) in the economically-productive 40 -59 age group. Conclusions: In general, no increase in hospital resource consumption was noted except among self-pay patients, the same group seemingly least able to afford expensive healthcare.
文摘Objective The evaluation index of medical equipment's economic benefit is based on the usage of medical equipment,the traditional data collection method is time-consuming,laborious and not entirely accurate.The usage of medical equipment is obtained by designing data query statements from the HIS system.Methods First the charging items are in correspondence with the device's name included,second fees and other relevant data are extracted from charging module in HIS.Through a rough estimate of the recovery period and an increase or decrease ratio,the economic benefit of the medical equipment can be analyzed.Results Through the method of the benefit analysis of the medical equipment,we can clearly find out the different economic benefit of the equipment,and finally analyze the reasons.Conclusion Practice has proved that,this methad,it can greatly reduce human,material resources required in data collection and improve the accuracy of the data.It can help hospital managers timely to grasp the operating costs of medical equipment and other information,and also provide scientific data for hospital managers when they purchase reasonable medical equipment.
文摘Introduction: As the U.S. population undergoes continuous shifts the population’s health profile changes dynamically resulting in more or less expression of certain psychiatric disorders and utilization of health-care resources. In this paper, we analyze national data on the psychiatric morbidity of American patients and their summated cost in different age groups. Methods: The latest data (2009) on the number of hospital discharges and national bill (hospital charges) linked with psychiatric disorders were extracted from the Nationwide Inpatient Sample (NIS). Results: National data shows that mood disorders are the largest diagnostic category in terms of percentage of psychiatri-crelated discharges in the 1 - 17 years age group. The proportion decreases gradually as age progresses while delirium, dementia, amnestic and other cognitive disorders increase exponentially after 65 years of age. Schizophrenia and other psychotic disorders as well as alcohol and substance-related disorders peak in the working age groups (18 - 64 years). From an economic point of view, mood disorders in the 18 - 44 age group has the highest national bill ($5.477 billion) followed by schizophrenic and other psychotic disorders in the same age group ($4.337 billion) and mood disorders in the 45 - 64 age group ($4.310 billion). On the third place come schizophrenic and other psychotic disorders in the 45 - 64 age group ($3.931 billion). Conclusion: This paper illustrates the high cost of psychiatric care in the U.S., especially the large fraction of healthcare money spent on working-age patients suffering from mood disorders. This underlines psychiatric cost-efficiency as a vital topic in the current healthcare debate.
基金supported by the ministry of health of the state key clinical specialist pediatric respiratory(No.9151008901000033)
文摘Background Congenital heart disease(CHD)is the most common congenital anomaly affecting 1.35 million newborns globally every year.Children affected by CHD would normally come across growth failure at a young age.As complex CHD has a high mortality rate,it needs to be corrected as soon as possible after birth.Methods The medical records of infants with diagnosed CHD according to International Classification of Diseases(ICD)10 th Revision codes(January 2009-June 2017)who underwent cardiac surgery were reviewed.In the 431 patients who met the study criteria,their clinical characteristics,outcomes and cost data were collected.Linear regression models were used to determine the hospitalization cost after adjustment for demographic and other risk factors.Results For the 431 patients who met the study criteria,the median hospital stay was 24 days(range 17~34 days),which was not significantly changed over 9 years.The median inflation-adjusted total hospital cost was ￥80634(range ￥ 64585~97831),which was on the increase.The predominant influential factors of hospitalization expenses were hospitalization days,hospitalization deaths,European surgical scores,postsurgical complications and preoperative ventilator assistance.The least amount of hospitalization expenses was spent when hospitalization stay≤10 days and ARISTOTLE surgery total score≤12.25.Hospitalization expenses were related to hospitalization days when it was 10 days to 24 days.The expenses of deaths were higher than the survivors when hospitalization stay was 25 days to 48 days,the number of postsurgical complications≥1.The expenses of deaths reached the highest when the hospital stay≥49 days with the number of postsurgical complications≥3.Conclusion The hospitalization expense of neonate’s CHD has been increasing in recent years.Different hospitalization stays and surgical procedure difficulties,postsurgical complications and hospital deaths could affect the total cost of hospitalization.
