Factors contributing to hospitalization expenditures for patients with COPD in Yunnan Province, China: a path analysis

Abstract Objective To understand the hospitalization expenditures and the composition of hospitalized patients with chronic obstructive pulmonary disease (COPD) in Yunnan Province from 2016 to 2022 and to identify the factors that influence them. The study aims to provide evidence-based information to health administration, hospitals, health insurance offices, and other related departments to help them formulate relevant policies. Methods This study analyzed data from 728,980 COPD patients in Yunnan Province between 2016 and 2022. This study described trends in hospitalization expenditures and their components over a 7-year period. Path analysis was used to investigate the factors that affect hospitalization expenditures. Results The average hospitalization expenditures for 2016–2022 were 7828 CNY. The total hospitalization expenditures were continuously increasing, from 828 million CNY to 967 million CNY, which is a 16.84% increase. However, the average expenditure per hospitalization decreased from 9185 CNY to 7261 CNY, which is a decrease of 20.95%. The main components of hospitalization expenditures were diagnostic fees, medication fees, and comprehensive medical service fees. The proportion of medication fees is decreasing, while the proportion of diagnostic fees and comprehensive medical services fees are increasing. The results of the path analysis indicate that age, gender, ethnicity, hospital level, admission route, medical payment method, COPD with acute lower respiratory tract infection, non-acute exacerbation of COPD, rehabilitation treatment experience, and comorbidity have both direct and indirect effects on hospitalization expenditures through length of stay (LOS). Additionally, marital status indirectly affects hospitalization expenditures through LOS. Conclusion Shortening the average LOS is crucial for hospitals to improve efficiency and reduce unnecessary expenses for patients. To achieve this, it is necessary to actively implement clinical pathway management and establish a standardized diagnosis and treatment system.