| Objective:This analysis identified the current situation and trend of inter-provincial medical tourism for inpatients in tertiary hospitals in China,and further aim at cardiovascular diseases so as to identify the current situation and trend of inter-provincial medical tourism for inpatients with cardiology and cardiac surgery.This analysis also analyzed the medical service outcome of inpatients with cardiovascular related major treatment techniques and the factors affecting inter-provincial medical tourism for cardiovascular inpatients,aiming at providing reference information for the government to formulate relevant policies.Materials and Methods:We applied the data of National Report on the Service,Quality and Safety in Medical Care System from 2016 to 2021 to describe the current situation and trend of inter-provincial medical tourism for inpatients in tertiary hospitals in China,which was all completed in SPSS 21.0.Cardiovascular disease related research data were derived from the case home page of cardiovascular inpatients(hereinafter referred to as patients)in tertiary hospitals in China from 2018 to 2021,including age,gender,residence,first-listed diagnosis,length of stay,in-hospital outcomes(discharge with medical advice,in-hospital mortality and discharge against medical advice),total fees,etc.A total of 1,388,209 cases of inter-provincial medical tourism cardiovascular inpatients were included.We described sociological characteristics,mobility characteristics,hospitalization characteristics and in-hospital outcomes.We performed the chi-square test to explore whether there is any difference in medical service outcomes between local inpatients and inter-provincial medical tourism cardiovascular inpatients,and used Boston Matrix and scatter plot to analyze the relationship between resource allocation and inter-provincial medical tourism.Results:(1)During 2015-2020,most of inter-provincial medical tourism were from the provinces of Anhui,Jiangsu,Hebei,Zhejiang and Henan.Cardiovascular and cerebrovascular diseases and cancers were the most common diseases in inter-provincial medical tourism,while the major treatment techniques included cesarean section,coronary intervention,intramuscular lens implantation and local mastectomy.Inter-provincial tourism typically had a lower average length of stay and in-hospital mortality rate,but higher overall cost,compared with local inpatients.(2)In 2021,the inpatients for inter-provincial medical tourism accounted for 3.8%of all the inpatients received in cardiovascular medicine,a slight decrease compared to 2018(4.6%)and 2019(4.7%)and 2020(4.0%).most of inter-provincial medical tourism were from the provinces of Anhui,Jiangsu,Hebei,Zhejiang and Henan,and the proportion from the east,middle and west China were 62.7%,15.1%and 22.3%respectively.From 2018 to 2021,a total of 1,244,221 cases of inter-provincial medical tourism in cardiovascular medicine were included in China,with a median age of 66(57-75)years old,accounting for 43.6%of women and 38.9%of urban employee basic medical insurance inpatients.The common first-listed diagnosis included coronary heart disease(56.7%),heart failure(19.5%),pulmonary vascular disease(5.3%),high blood pressure(4.2%)and arrhythmia(3.9%),and the rates of discharge with medical advice,discharge against medical advice and in-hospital mortality were 87.9%,5.2%and 2.2%,respectively.(3)In 2021,the inpatients for inter-provincial medical tourism accounted for 15.0%of all the inpatients received in cardiovascular surgery,a slight decrease compared to 2018(17.4%)and 2019(16.9%)and 2020(15.1%).most of inter-provincial medical tourism were from the provinces of Anhui,Jiangsu,Hebei,Zhejiang and Henan,and the proportion from the east,middle and west China were 71.8%,9.9%and 18.3%respectively.From 2018 to 2021,a total of 143,988 cases of inter-provincial medical tourism in cardiovascular surgery were included in China,with a median age of 54(33,65)years,accounting for 40.6%of women and 38.2%of urban employee basic medical insurance inpatients,and the rates of discharge with medical advice,discharge against medical advice and in-hospital mortality were 94.2%,1.4%and 1.5%,respectively.(4)After adjusting the characteristics of inpatients’ age,gender and complications by risk-adjusted model,inter-provincial tourism typically had a lower average length of stay and in-hospital mortality and discharge against medical advice rate,but higher overall cost,compared with local cardiovascular treatment techniques inpatients(P<0.05).(5)In cardiac medicine,the number of doctors(0.36)and beds(0.15)per capita is positively correlated with the rate of net inflows.In cardiac surgery,the number of doctors(0.39)and beds(0.45)per capita is positively correlated with the the rate of net inflows.Conclusion:(1)Compared with all diseases,cardiovascular disease is still a major disease that affects the health of residents.(2)There was a downward trend in the rate accounted for inter-provincial medical tourism of the inpatients received in cardiovascular medicine and surgery.Most of inter-provincial medical tourism were from the provinces of Anhui,Jiangsu,Hebei and Zhejiang.(3)Inter-provincial medical tourism received in CVD were affected by many factors.(4)For inpatients who received in CVD,inter-provincial tourism typically resulted in a better in-hospital outcome,but a higher overall cost compared to local inpatients. |
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