Healthcare for Patients with Hepatitis B Virus: Analysis of 367 381 Inpatient Cases in China

Abstract

Objective

Hepatitis B virus (HBV) infection, which has been recognized as an international public health challenge, has caused significant morbidity for the entire world. This research focused on patients with HBV in China to examine health utilization and expenses.

Methods

Patients hospitalized with HBV from 2017 to 2019 in tertiary hospitals in Hubei, a province located in central China, were selected as the study population. Healthcare information was collected from the provincial inpatient electronic system database. Univariate and regression analyses were performed to describe the basic situation of healthcare services and determine the influencing indicators of inpatient service expenditure.

Results

A total of 367 381 cases of HBV infection were identified in the study area. Most of these cases were patients who were married (90.2%) and males (63%). With the great efforts by the universal coverage of the basic medical insurance (BMI) in China, the increasing rate of inpatient hospitalization for HBV was 3.5 times higher than that of the total inpatient health service cases in the study area. The average age of this group was 52.84±14.10 years and 11.1% of patients paid for their own medical expenditures without insurance. The average length of stay (LOS) was 11.10 days, and the average cost per patient was 15 712.05 RMB. Both values were higher than the average level in study area. Gender, marital status, career, payment type, and kind of hospitals significantly influenced healthcare utilization. Males and the elderly might incur higher healthcare costs than their counterparts.

Conclusion

The BMI operated by government has played a role in the utilization release of health services for HBV carriers. However, researchers must pay more attention to the continuing increase in the medical expenses of this group.

Keywords

healthcare utilization / expenditure / hepatitis B virus infection / inpatients / hospitalization

References

[1] Chinese Center for Disease Control and Prevention (CDC). Strategy and progress of hepatitis B prevention and control in China (Chinese). In http://www.chinacdc.cn/jkzt/crb/zl/bdxgy/yxbdxgy/201301/t20130106_75114.html; 2013-01-16.

[2] MigliettaA, QuintenC, LopalcoPL, et al.. Impact of hepatitis B vaccination on acute hepatitis B epidemiology in European Union/European Economic Area countries, 2006 to 2014. Euro Surveill, 2018, 23(6): 17-00278

[3] World Health Organization (WHO). Global hepatitis report 2017. In https://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/. Geneva; 2017

[4] WHO. Hepatities B. In https://www.who.int/news-room/fact-sheets/detail/hepatitis-b. 2020-07-27

[5] YangBFStudy on the seroepidemic situation of HBV and evaluation HepB vaccine in Hubei Province, 2013, Wuhan, Huazhong University of Science and Technology

[6] LiuJ, LiangW, JingW, et al.. Countdown to 2030: eliminating hepatitis B disease, China. Bull World Health Organ, 2019, 97(3): 230-238

[7] Centers for Disease Control and Prevention, U.S. Hepatitis B information. In https://wwwnc.cdc.gov/travel/diseases/hepatitis-b. 2020-04-28.

[8] SarinSK, KumarM, EslamM, et al.. Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol, 2020, 5(02): 167-228

[9] HehleV, BerettaM, BourgineM, et al.. Potent human broadly neutralizing antibodies to hepatitis B virus from natural controllers. J Exp Med, 2020, 217(10): e20200840

[10] ChakE, LiCS, ChenMSJr, et al.. Electronic health record alerts enhance mass screening for chronic hepatitis B. Sci Rep, 2020, 10: 19153

[11] TianX, WangL, WeiS, et al.. Age period cohort (APC) model of hepatitis B incidence in 0–10 years old population in Hubei Province from 2004 to 2016. Chin J Health Statist (Chinese), 2018, 35(03): 388-390

[12] SunYL, GregersenH, YuanW. Chinese health care system and clinical epidemiology. Clin Epidemiol, 2017, 9: 167-178

[13] WangFZ, ZhangGM, ShenLP, et al.. Comparative analyze on hepatitis B seroepidemiological surveys among population aged 1–29 years in different epidemic regions of China in 1992 and 2014. Chin J Prev Med (Chinese), 2017, 51(06): 462-468

[14] JinYY, GengN, ZhaoLR, et al.. The Prevalence of HBV Infection: A Retrospective Study of 13 Years in a Public Hospital of Northeast China. Viral Immunol, 2020, 33(02): 99-104

[15] WangH, MenPX, XiaoYF, et al.. Hepatitis B infection in the general population of China: a systematic review and meta-analysis. BMC Infect Dis, 2019, 19(01): 811

[16] LüJJ, LiRP, XuAQ, et al.. Economic burden and related factors on inpatients with HBV related diseases in Shandong province. Chin J Epidemiol, 2013, 34(03): 267-272

[17] WangYT, HuangHY, QingHS, et al.. Medical expenditure of hepatitis B virus infection and its impact factors anlaysis in Qidong, Jiangsu Province. J Clin Hepatol (Chinese), 2017, 33(01): 61-66

[18] FuHL, ChenXB. Chronic hepatitis B virus infectors’ use of medical services and the expenses incurred. Chin J Hosp Admin (Chinese), 2004, 20(07): 25-28

[19] LiuJ, ZhangSK, WangQM, et al.. Seroepidemiology of hepatitis B virus infection in 2 million men aged 21–49 years in rural China: a population-based, cross-sectional study. Lancet Infect Dis, 2016, 16(01): 80-86

[20] YangSJ, DongHJ. A study on direct economic burden of chronic hepatitis B — relevant diseases. Zhejiang Prev Med (Chinese), 2015, 27(01): 1-5+9

[21] Health Commission of Hubei Province. Reply to the Proposal of the Second Session of the 12th CPPCC of Hubei Province. In http://wjw.hubei.gov.cn/zfxxgk/fdzdgknr/qtzdgknr/jytabl/202008/t20200807_2753504.shtml. 2019-08-27

[22] DaiP, WangXN, GuanXH, et al.. Epidemiological analysis of acute viral hepatitis B, Hubei, 2012–2017. Mod Prevent Med (Chinese), 2019, 46(01): 5-8

[23] QingDEpidemic characteristics and serological investigation of hepatitis B in Hubei Province from 2012 to 2016 (Chinses version), 2017, Wuhan, Wuhan University of Science and Technology