Dataset Information

Direct medical costs of hospitalisations for mental disorders in Shanghai, China: a time series study.

ABSTRACT: OBJECTIVES:To provide cost burden estimates and long-term trend forecast of mental disorders that need hospitalisations in Shanghai, China. DESIGN:Daily hospital admissions and medical expenditures for mental disorder hospitalisations between 1 January 2011 and 31 December 2015 were used for analysis. Yearly total health expenditures and expenditures per hospital admission for different populations, as well as per-admission-per-year medical costs of each service for mental disorder hospitalisations, were estimated through data from 2015. We also established time series analyses to determine the long-time trend of total direct medical expenditures for mental disorders and forecasted expenditures until 31 December 2030. SETTING:Shanghai, China. PARTICIPANTS:Daily hospital admissions for mental disorders of registered residents living in all 16 districts of Shanghai, who participated in workers' basic medical insurance or the urban residents' basic medical insurance (n=60?306). RESULTS:From 2011 to 2015, there were increased yearly trends for both hospitalisations (from 10?919 to 14 054) and total costs (from US$23.56 to 42.13?million per year in 2015 currency) in Shanghai. Cost per mental disorder hospitalisation in 2015 averaged US$2998.01. Most direct medical costs were spent on medical supplies. By the end of 2030, the average cost per admission per month for mental disorders was estimated to be US$7394.17 (95% CI US$6782.24 to 8006.10) for mental disorders, and the total health expenditure for mental disorders would reach over US$100.52?million (95%?CI US$92.20 to 108.83?million) without additional government interventions. CONCLUSIONS:These findings suggest total health expenditures for mental disorders in Shanghai will be higher in the future. Effective measures should be taken to reduce the rapid growth of the economic burden of mental disorders.

SUBMITTER: Chen W

PROVIDER: S-EPMC5665299 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Direct medical costs of hospitalisations for mental disorders in Shanghai, China: a time series study.

Chen Wenming W Wang Shengnan S Wang Qi Q Wang Weibing W

BMJ open 20171030 10

<h4>Objectives</h4>To provide cost burden estimates and long-term trend forecast of mental disorders that need hospitalisations in Shanghai, China.<h4>Design</h4>Daily hospital admissions and medical expenditures for mental disorder hospitalisations between 1 January 2011 and 31 December 2015 were used for analysis. Yearly total health expenditures and expenditures per hospital admission for different populations, as well as per-admission-per-year medical costs of each service for mental disorde ...[more]

PMID: 29084785

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Project description:We analyzed the incidence of medical complications after osteoporotic fractures and estimated its risk factors and cost impacts. Osteoporotic fractures can result in lots of serious medical complications, which is associated with patients' baseline characteristics such as patients' disease history and significantly increased patients' direct medical costs. PURPOSE:The purpose of the study is to investigate the incidence and identify the risk factors of medical complications after osteoporotic fracture, and quantify patients' economic burden. METHODS:Data were obtained from the Tianjin Urban Employee Basic Medical Insurance database (2009-2014). Patients aged ??50 years, had ??1 diagnoses of hip or vertebral fracture between 2010 and 2012, and continuously enrolled from 12 months before to 24 months after the first identified fracture were included. The incidence of medical complications was estimated within 12 months before and after fracture. Direct medical costs were measured and compared between patients with at least one medical complication and without any medical complications. Logistic regression was applied to identify risk factors for any medical complications. RESULTS:Three thousand seven hundred nineteen patients were identified; 45.0% had hip fracture, and 56.2% had vertebral fracture. After osteoporotic fracture, the accumulative incidence of the most common medical complications including constipation (25.6%, RR 1.38 [1.28, 1.48]), stroke (25.2%, 1.16 [1.09, 1.24]), pneumonia (17.0%, 1.55 [1.40, 1.73]), urinary tract infection (16.3%, 1.23 [1.12, 1.36]), and arrhythmia (11.8%, 1.39 [1.23, 1.56]) was significantly higher than that before fracture. Advanced age; male sex; retirement status; diagnosis of hypertension, chronic heart disease, cerebrovascular disease, hemiplegia, or Parkinson's disease; and higher direct medical costs at baseline were significant predictors of complications. The all-cause direct medical cost during 24-month follow-up was $5665. Medical complications significantly increased patients' direct medical costs. CONCLUSIONS:Osteoporotic fractures led to amount of medical complications, which significantly increased patients' economic burden. Complications correlate to various factors such as patients' disease history.

Project description:Background:Mental disorders endanger people's health and lives. General practitioners (GPs) play a valuable role in identifying and treating mental disorders in outpatient clinical settings. However, there are obstacles for GPs' identification in developing countries. Objective:This study's aim was to identify the related obstacles and to propose optimized strategies. Methods:We conducted qualitative interviews with 26 GPs from seven randomly sampled community healthcare centers in Shanghai, China. The interview guide was based primarily on the items from mental status evaluation. After transcribing, coding, condensing, and categorizing talking content, we summarized the theme structure and results. Findings:GPs lacked the confidence and skills to conduct psychiatric evaluation and seldom conducted it. Patients' behaviors also influenced whether evaluations were conducted. The GPs expressed that they were short of strategies and wished to be well trained and have sufficient practice. We found that two major reasons impeded GPs' identification. First, the GPs had difficulty making a diagnosis: they lacked diagnostic ability and confidence, they had misunderstandings about diagnoses, and they had unclear qualifications for making psychiatric diagnoses. Second, the GPs lacked skills for evaluation and reevaluation: their evaluation had inadequacies of contents and subjects; they lacked mental state examination evaluation, communication, and severity assessment skills and knowledge. Conclusions:This study found that it is difficult for GPs in developing countries to become competent in the diagnosis and systematic evaluation of mental disorders without external help. Unclear qualification also limited GPs' diagnoses of mental disorders. We proposed that optimized strategies to overcome these challenges lie in support of changes in policy, programs, and utilizing effective tools, such as the mhGAP, GMHAT/PC, BVC, Grille's assessment tool, and telemedicine.

Dataset Information

Direct medical costs of hospitalisations for mental disorders in Shanghai, China: a time series study.

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Direct medical costs of hospitalisations for mental disorders in Shanghai, China: a time series study.

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