TY - JOUR
T1 - Healthcare resource utilisation for chronic kidney disease and other major non-communicable chronic diseases in China
T2 - A cross-sectional study
AU - Yang, Chao
AU - Long, Jianyan
AU - Shi, Ying
AU - Zhou, Zhiye
AU - Wang, Jinwei
AU - Zhao, Ming Hui
AU - Wang, Haibo
AU - Zhang, Luxia
AU - Coresh, Josef
N1 - Funding Information:
Funding This study was supported by grants from the National Natural Science Foundation of China (82003529, 91846101, 81771938, 81900665, 82090021), Beijing Nova Programme Interdisciplinary Cooperation Project (Z191100001119008), National Key R&D Program of the Ministry of Science and Technology of China (2019YFC2005000), Chinese Scientific and Technical Innovation Project 2030 (2018AAA0102100), University of Michigan Health System-Peking University Health Science Center Joint Institute for Translational and Clinical Research (BMU2018JI012, BMU2019JI005, 71017Y2027), CAMS Innovation Fund for Medical Sciences (2019-I2M-5-046), and PKU-Baidu Fund (2019BD017, 2020BD032). Competing interests JC was partly supported by grants to the CKD Prognosis Consortium by the National Kidney Foundation and NIH. Patient consent for publication Not required. Ethics approval This study involves human participants and was approved by the Ethics Committee of Peking University First Hospital (2015-928). Informed consent was waived by the ethics committee.
Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/1/13
Y1 - 2022/1/13
N2 - Objective To evaluate the healthcare resource utilisation for chronic kidney disease (CKD) and other major non-communicable chronic diseases (NCDs) in China. Design A cross-sectional study. Setting A national inpatient database of tertiary hospitals in China. Participants The study included a total of 19.5 million hospitalisations of adult patients from July 2013 to June 2014. Information on CKD and other major NCDs, including coronary heart disease (CHD), stroke, hypertension, diabetes, chronic obstructive pulmonary disease (COPD) and cancer, was extracted from the unified discharge summary form. Outcome measures Cost, length of hospital stay and in-hospital mortality. Results The percentages of hospitalisations with CKD, CHD, stroke, hypertension, diabetes, COPD and cancer were 4.5%, 9.2%, 8.2%, 18.8%, 7.9%, 2.3% and 19.4%, respectively. For each major NCD, the presence of CKD was independently associated with longer hospital stay, with increased percentages ranging from 7.69% (95% CI 7.11% to 8.28%) for stroke to 21.60% (95% CI 21.09% to 22.10%) for CHD. Hospital mortality for other NCDs was also higher in the presence of CKD, with fully adjusted relative risk ranging from 1.91 (95% CI 1.82 to 1.99) for stroke to 2.65 (95% CI 2.55 to 2.75) for cancer. Compared with other NCDs, CKD was associated with the longest hospital stay (22.1% increase) and resulted in the second highest in-hospital mortality, only lower than that of cancer (relative risk, 2.23 vs 2.87, respectively). Conclusions The presence of diagnosed CKD alongside each major NCD was associated with an additional burden on the healthcare system. Healthcare resource utilisation and prognosis of CKD were comparable with those of other major NCDs, which highlights the importance of CKD as a major public health burden.
AB - Objective To evaluate the healthcare resource utilisation for chronic kidney disease (CKD) and other major non-communicable chronic diseases (NCDs) in China. Design A cross-sectional study. Setting A national inpatient database of tertiary hospitals in China. Participants The study included a total of 19.5 million hospitalisations of adult patients from July 2013 to June 2014. Information on CKD and other major NCDs, including coronary heart disease (CHD), stroke, hypertension, diabetes, chronic obstructive pulmonary disease (COPD) and cancer, was extracted from the unified discharge summary form. Outcome measures Cost, length of hospital stay and in-hospital mortality. Results The percentages of hospitalisations with CKD, CHD, stroke, hypertension, diabetes, COPD and cancer were 4.5%, 9.2%, 8.2%, 18.8%, 7.9%, 2.3% and 19.4%, respectively. For each major NCD, the presence of CKD was independently associated with longer hospital stay, with increased percentages ranging from 7.69% (95% CI 7.11% to 8.28%) for stroke to 21.60% (95% CI 21.09% to 22.10%) for CHD. Hospital mortality for other NCDs was also higher in the presence of CKD, with fully adjusted relative risk ranging from 1.91 (95% CI 1.82 to 1.99) for stroke to 2.65 (95% CI 2.55 to 2.75) for cancer. Compared with other NCDs, CKD was associated with the longest hospital stay (22.1% increase) and resulted in the second highest in-hospital mortality, only lower than that of cancer (relative risk, 2.23 vs 2.87, respectively). Conclusions The presence of diagnosed CKD alongside each major NCD was associated with an additional burden on the healthcare system. Healthcare resource utilisation and prognosis of CKD were comparable with those of other major NCDs, which highlights the importance of CKD as a major public health burden.
KW - chronic renal failure
KW - epidemiology
KW - public health
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U2 - 10.1136/bmjopen-2021-051888
DO - 10.1136/bmjopen-2021-051888
M3 - Article
C2 - 35027417
AN - SCOPUS:85123568537
SN - 2044-6055
VL - 12
JO - BMJ Open
JF - BMJ Open
IS - 1
M1 - e051888
ER -