Status of epilepsy inpatients healthcare in national tertiary public hospitals: analysis of Hospital Quality Monitoring System_West China Medical Journal

Authors：

ZHANG Hesheng ¹ , LU Lu ¹ , XIONG Weixi ¹ , YANG Xin ^2,3 , WANG Caiyun ^2,3 , LI Zixiao ^2,3,4 , WANG Yongjun ^2,3,4 , ZHOU Dong ¹ ,  FAN Jing ^5,6

1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, P. R. China;
3. National Center for Healthcare Quality Management in Neurological Diseases, Beijing 100070, P. R. China;
4. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, P. R. China;
5. National Center for Cardiovascular Diseases, Beijing 100037, P. R. China;
6. Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, P. R. China;

Corresponding?author：

FAN Jing, Email: fj1004@hotmail.com

Keywords：

Inpatients; Hospital Quality Monitoring System; Healthcare

DOI：

10.7507/1002-0179.202003486

Video：

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Objective To describe the status of epilepsy inpatients healthcare service in tertiary public hospitals in China by the data collected from the Hospital Quality Monitoring System.Methods A population-based study was conducted with data of hospitalized patients collected from the Hospital Quality Monitoring System between 2015 and 2017. Diagnoses were identified by International Statistical Classification of Diseases and Related Health Problems 10th Revision codes for epilepsy (G40). The information of demographic characteristics, costs, payment methods, and discharge status were extracted and analyzed annually to make cross-sectional studies.Results A total of 329 241 hospitalized epilepsy patients from 585 tertiary public hospitals were identified. The average age of the patients was 31.74 and male patients accounted for 60.00% of the total. The proportion of patients covered by the national basic medical insurance in the three years was 50.15%, and that in the year 2015, 2016, and 2017 was 49.03%, 49.79%, and 51.80%, respectively; the proportion of patients with full self-payment was 30.40%. The average length of hospital stay was 6.65 d, the average cost for each stay was 7 985.53 yuan, the average self-payed cost for each stay was 3 979.62 yuan. In terms of the discharge way of the patients, 88.02% discharged following doctors’ advice, 0.40% were transferred to another hospital with doctors’ advice, and 6.59% discharged against doctors’ advice. The in-hospital mortality in the three years was 0.16%, and that in the year 2015, 2016, and 2017 was 0.19%, 0.16%, and 0.12%, respectively.Conclusion The study shows that the in-hospital mortality rate of epilepsy inpatients in the tertiary public hospitals in China decreased gradually from 2015 to 2017, the coverage rate of national basic medical insurance increased year by year, and there is still room for further improvement.

Citation： ZHANG Hesheng, LU Lu, XIONG Weixi, YANG Xin, WANG Caiyun, LI Zixiao, WANG Yongjun, ZHOU Dong, FAN Jing. Status of epilepsy inpatients healthcare in national tertiary public hospitals: analysis of Hospital Quality Monitoring System. West China Medical Journal, 2020, 35(6): 679-683. doi: 10.7507/1002-0179.202003486 Copy

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1. Fisher RS, Boas WVE, Blume W, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia, 2005, 46(4): 470-472.
2. 中華醫學會. 臨床診療指南?癲癇病分冊2015修訂版. 北京: 人民衛生出版社, 2015: 11.
3. Fullman N, Yearwood J, Abay SM, et al. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016. Lancet, 2018, 391(10136): 2236-2271.
4. 國家神經系統疾病醫療質量控制中心. 2018神經系統疾病醫療質量報告. 北京: 人民衛生出版社, 2019: 4-15.
5. 衛生部. 住院病案首頁部分項目填寫說明. (2011-12-02)[2019-12-25]. http://www.nhc.gov.cn/zwgk/wtwj/201304/47b4226ff93c4800bab61c045ddb6642.shtml.
6. Mitchell RJ, Herkes G, Nikpour A, et al. Examining health service utilization, hospital treatment cost, and mortality of individuals with epilepsy and status epilepticus in New South Wales, Australia 2012–2016. Epilepsy Behav, 2018, 79: 9-16.
7. 國家統計局. 2018年居民收入和消費支出情況. (2019-01-21)[2019-12-25]. http://www.stats.gov.cn/tjsj/zxfb/201901/t20190121_1645791.html.
8. Hong Z, Qu B, Wu XT, et al. Economic burden of epilepsy in a developing country: a retrospective cost analysis in China. Epilepsia, 2009, 50(10): 2192-2198.
9. Gazzola DM, Thawani S, Agbe-Davies O, et al. Epilepsy monitoring unit length of stay. Epilepsy Behav, 2016, 58: 102-105.
10. Vivas AC, Baaj AA, Benbadis SR, et al. The health care burden of patients with epilepsy in the United States: an analysis of a nationwide database over 15 years. Neurosurg Focus, 2012, 32(3): 1-7.
11. Yip W, Fu H, Chen AT, et al. 10 years of health-care reform in China: progress and gaps in Universal Health Coverage. Lancet, 2019, 394(10204): 1192-1204.
12. 國家神經內科醫療質量控制中心. 2017神經內科醫療質量報告. 北京: 人民衛生出版社, 2018: 72.
13. 人力資源社會保障部, 財政部. 人力資源社會保障部財政部關于做好基本醫療保險跨省異地就醫住院醫療費用直接結算工作的通知. (2016-12-08)[2019-12-25]. http://www.mohrss.gov.cn/SYrlzyhshbzb/shehuibaozhang/zcwj/201612/t20161215_262040.html.
14. 國家醫療保障局. 基本醫療保險跨省異地就醫住院醫療費用直接結算公共服務信息發布(第七期). (2019-01-08)[2019-12-25]. http://www.nhsa.gov.cn/art/2019/1/18/art_18_847.html.
15. 國家衛生健康委員會. 國家衛生健康委員會2019年10月9日例行新聞發布會文字實錄. (2019-10-09)[2019-12-25]. http://www.nhc.gov.cn/xcs/s7847/201910/03dd66a63a8c4539879991f0221a07fa.shtml.
16. Spooner KK, Salemi JL, Salihu HM, et al. Discharge against medical advice in the United States, 2002-2011. Mayo Clin Proc, 2017, 92(4): 525-535.
17. Kwon CS, Agrawal P, Goldstein J, et al. Risk of readmission for injury in patients with epilepsy in the United States - a population-based study. Epilepsy Behav, 2020, 102: 106651.
18. 李曉東. 非醫囑離院病例相關因素分析. 中國病案, 2019, 20(4): 71-74.
19. 國家衛生健康委統計信息中心. 2019年5月底全國醫療衛生機構數. (2019-07-31)[2019-12-25]. http://www.nhc.gov.cn/mohwsbwstjxxzx/s7967/201907/2320f85d7ff446009a88cf839dadf624.shtml.
20. 國家衛生健康委統計信息中心. 2019年1-6月全國醫療服務情況. (2019-08-29)[2019-12-25]. http://www.nhc.gov.cn/mohwsbwstjxxzx/s7967/201908/407530a66cb44489aa276b4cc9e24c43.shtml.

West China Medical Journal

Status of epilepsy inpatients healthcare in national tertiary public hospitals: analysis of Hospital Quality Monitoring System

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