Background <p>Esophagogastric variceal bleeding (EGVB) is a life-threatening complication of decompensated cirrhosis that imposes a substantial inpatient economic burden. However, the specific determinants and cost composition of EGVB hospitalization remain poorly defined in China.</p> Methods <p>We retrospectively analyzed 122 patients admitted with EGVB between April 2019 and July 2023 at the First Hospital of Lanzhou University. Demographic, clinical, and itemized cost data were retrieved from electronic records. Total hospitalization cost was log-transformed and examined by stepwise multiple linear regression to identify independent predictors. K-means clustering was used to explore patterns in cost composition.</p> Results <p>The median cost was CNY 34,744. Surgical type, length of stay, and insurance category were the strongest predictors of total cost (R² = 0.81, <i>P</i> &lt; 0.01). Western medication and procedural expenses constituted the largest cost components, while hospital duration and discharge status had smaller effects.</p> Conclusions <p>In patients with EGVB secondary to decompensated cirrhosis, surgical approach and insurance coverage drive inpatient expenditure. Optimizing clinical pathways and financial policies could reduce the direct medical burden and enhance value-based liver care in China.</p>

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Determinants and cost composition of hospitalization for EGVB in decompensated cirrhosis

  • Yulan Song,
  • Rongwei Ren,
  • Ruxuan Li,
  • Mingyang Zou,
  • Yixin Pan,
  • Jiebin Pan,
  • Changpeng Chai

摘要

Background

Esophagogastric variceal bleeding (EGVB) is a life-threatening complication of decompensated cirrhosis that imposes a substantial inpatient economic burden. However, the specific determinants and cost composition of EGVB hospitalization remain poorly defined in China.

Methods

We retrospectively analyzed 122 patients admitted with EGVB between April 2019 and July 2023 at the First Hospital of Lanzhou University. Demographic, clinical, and itemized cost data were retrieved from electronic records. Total hospitalization cost was log-transformed and examined by stepwise multiple linear regression to identify independent predictors. K-means clustering was used to explore patterns in cost composition.

Results

The median cost was CNY 34,744. Surgical type, length of stay, and insurance category were the strongest predictors of total cost (R² = 0.81, P < 0.01). Western medication and procedural expenses constituted the largest cost components, while hospital duration and discharge status had smaller effects.

Conclusions

In patients with EGVB secondary to decompensated cirrhosis, surgical approach and insurance coverage drive inpatient expenditure. Optimizing clinical pathways and financial policies could reduce the direct medical burden and enhance value-based liver care in China.