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Trajectories of Hospitalization Cost Among Patients of End-Stage Lung Cancer: A Retrospective Study in China

1
School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China
2
School of Health Policy and Management, Nanjing Medical University, Nanjing 211166, China
3
Yichang Center for Disease Control and Prevention, Yichang 443000, China
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(12), 2877; https://doi.org/10.3390/ijerph15122877
Received: 22 October 2018 / Revised: 24 November 2018 / Accepted: 10 December 2018 / Published: 15 December 2018
(This article belongs to the Section Health Economics)
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Abstract

This study was conducted to investigate the trajectory of hospitalization costs, and to assess the determinants related to the membership of the identified trajectories, with the view of recommending future research directions. A retrospective study was performed in urban Yichang, China, where a total of 134 end-stage lung cancer patients were selected. The latent class analysis (LCA) model was used to investigate the heterogeneity in the trajectory of hospitalization cost amongst the different groups that were identified. A multi-nominal logit model was applied to explore the attributes of different classes. Three classes were defined as follows: Class 1 represented the trajectory with minimal cost, which had increased over the last two months. Classes 2 and 3 consisted of patients that incurred high costs, which had declined with the impending death of the patient. Patients in class 3 had a higher average cost than those in Class 2. The level of education, hospitalization, and place of death, were the attributes of membership to the different classes. LCA was useful in quantifying heterogeneity amongst the patients. The results showed the attributes were embedded in hospitalization cost trajectories. These findings are applicable to early identification and intervention in palliative care. Future studies should focus on the validation of the proposed model in clinical settings, as well as to identify the determinants of early discharge or aggressive care. View Full-Text
Keywords: end-of-life; lung cancer; cost trajectory; place of death; palliative care; latent class analysis; China end-of-life; lung cancer; cost trajectory; place of death; palliative care; latent class analysis; China
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Li, Z.; Jiang, S.; He, R.; Dong, Y.; Pan, Z.; Xu, C.; Lu, F.; Zhang, P.; Zhang, L. Trajectories of Hospitalization Cost Among Patients of End-Stage Lung Cancer: A Retrospective Study in China. Int. J. Environ. Res. Public Health 2018, 15, 2877.

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