Economic burden of hospitalized patients with echinococcosis in Xinjiang from 2014 to 2023

doi:10.12140/j.issn.1000-7423.2026.02.019

Abstract

Abstract:

Objective To estimate the overall economic burden of echinococcosis patients in Xinjiang from 2014 to 2023 and to identify its influencing factors, so as to provide the scientific evidence for formulation and improvements of medical control strategies for echinococcosis in Xinjiang. Methods A total of 8 hospitals were sampled from Xinjiang by means of stratified sampling and convenience sampling, including 4 Class Ⅲ Grade A hospitals and 4 Class Ⅱ Grade A hospitals. Medical records were collected from hospitalized patients with a primary diagnosis of echinococcosis from January 1, 2014 to December 31, 2023, and variables were retrieved from medical records, including gender, age, ethnicity, length of hospital stay, hospitalization cost, hospital level, region, surgical treatment, health insurance status, and type of echinococcosis. Subjects’ demographics and cost distribution were analyzed with descriptive statistics. Univariate analysis was performed with Mann-Whitney U test and Kruskal-Wallis H test, and independent factors affecting hospitalization costs were identified using a logarithmic multiple linear regression model (stepwise method). Indirect economic burden was calculated with disability-adjusted life year (DALY) combined with the human capital method using the following formula: indirect economic burden = gross national product per capita × DALY × productivity weight. SPSS 24.0 was used for statistical analyses. Results A total of 5 184 hospitalized patients with echinococcosis were included. The number of patients discharging from hospital peaked in 2017 (865 cases), dropped to the lowest in 2022 (230 cases, a decrease of 73.4% compared with the peak), and rebounded to 361 cases in 2023. The subjects had a median age of 44 years, and were primarily at ages of 45 to 59 years (32.9%, 1 703 cases). Of all subjects, 54.5% (2 823 cases) were men, and 90.1% (4 670 cases) suffered from cystic echinococcosis. Hospitalization costs showed a skewed distribution, with the median increasing from 23 137.2 Yuan in 2014 to 34 921.0 Yuan in 2022. The mean hospitalization cost was higher for alveolar echinococcosis patients (71 302.7 Yuan) than for cystic echinococcosis patients (29 397.3 Yuan; Z = -11.750, P < 0.05), and the mean hospitalization cost was higher among patients from northern Xinjiang (36 283.3 Yuan) was higher than those from southern Xinjiang (17 703.7 Yuan)(Z = -19.701, P < 0.05). The highest mean cost was seen among patients with length of hospital stay exceeding 30 days (106 761.4 Yuan; H = 1 263.033, P < 0.05). Logarithmic multiple linear regression analysis identified length of hospital stay (β = 0.414), surgical treatment (β = ‒0.471), hospital level (β = 0.210), region, type of echinococcosis, age, and health insurance status as independent factors affecting hospitalization costs (adjusted R² = 0.553, P < 0.05). Indirect economic burden analysis showed that echinococcosis caused a total of 10 007.3 DALYs lost during the study period, with an mean loss of 2.0 DALYs per patient. Patients at ages of 15 to 44 years had the highest disease burden, with a total DALY loss of 5 465.0 person-years, accounting for 54.6% of the total loss. The total indirect economic burden was 423.823 million Yuan, with a mean indirect economic burden of 82 000 Yuan per patient. Conclusion The economic burden of echinococcosis patients shows significant structural differences in Xinjiang. Alveolar echinococcosis is the core disease type leading to high medical costs, and its resource consumption pattern is essentially different from that of cystic echinococcosis. Young and middle-aged populations at ages of 15 to 44 years have more than half of the productivity loss and is the main population affected by indirect economic burdens.

Key words: Echinococcosis, Hospitalization cost, Indirect economic burden, Influencing factor

CLC Number:

R532.32

WANG Le, GU Ruijuan, TONG Chao, NIU Jiangshui, A Mengke, SU Xiaohong, REN Yanjun, LIU Jingdong, DENG Dawei, WEN Hao. Economic burden of hospitalized patients with echinococcosis in Xinjiang from 2014 to 2023[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2026, 44(2): 277-283.

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References 21

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年份 Year	男 Male		女 Female		合计 Total
年份 Year	病例数 No. patient	构成比/% Constituent/%	病例数 No. patient	构成比/% Constituent/%	病例数 No. patient		构成比/% Constituent/%
2014	337	11.9	257	10.9	594	11.5
2015	305	10.8	275	11.6	580	11.2
2016	361	12.8	274	11.6	635	12.2
2017	465	16.5	400	16.9	865	16.7
2018	314	11.1	310	13.1	624	12.0
2019	325	11.5	279	11.8	604	11.7
2020	178	6.3	156	6.6	334	6.4
2021	199	7.0	158	6.7	357	6.9
2022	135	4.8	95	4.0	230	4.4
2023	204	7.2	157	6.6	361	7.0
合计 Total	2 823	100	2 361	100	5 184	100

民族 Nationality	细粒棘球蚴病 Cystic echinococcosis		多房棘球蚴病 Alveolar echinococcosis		合计 Total
民族 Nationality	病例数 No. patient	构成比/% Constituent/%	病例数 No. patient	构成比/% Constituent/%	病例数 No. patient	构成比/% Constituent/%
哈萨克族 Kazak	626	13.4	179	34.8	805		15.5
汉族 Han	1 838	39.4	187	36.4	2 025		39.1
回族 Hui	393	8.4	26	5.1	419		8.1
蒙古族 Mongol	277	5.9	59	11.5	336		6.5
维吾尔族 Uygur	1 379	29.5	34	6.6	1 413		27.3
其他 Other	157	3.4	29	5.6	186		3.6
合计 Total	4 670	100	514	100	5 184		100

影响因素 Influencing Factor	代码 Code	量化单位 Unit of Quantification
年龄 Age	X₁	岁 Years
住院天数 Length of stay	X₂	天 Days
性别 Gender	X₃	1 = 男 Male 2 = 女 Female
医院等级 Hospital level	X₄	1 = 二级甲等 Class Ⅱ Grade A 2 = 三级甲等 Class Ⅲ Grade A
地区 Region	X₅	1 = 北疆 Northern Xinjiang 2 = 南疆 Southern Xinjiang
是否手术 Surgical procedure	X₆	1 = 手术 Yes 2 = 未手术 No
是否医保 Health insurance	X₇	1 = 是 Yes 2 = 否 No
棘球蚴病类型 Type of echinococcosis	X₈	1 = 细粒棘球蚴病 Cystic echinococcosis 2 = 多房棘球蚴病 Alveolar echinococcosis

变量 Variable	偏回归系数 Partial regression coefficient	偏回归系数标准误 Standard error of partial regression coefficient	标准偏回归系数 Standardized partial regression coefficient	t	P
常项量Constant	9.146	0.097		94.665	0
年龄Age	0.004	0	0.07	7.331	0
住院天数 Length of stay	0.039	0.001	0.414	40.749	0
性别Gender	-0.014	0.017	-0.008	-0.823	0.411
医院等级Hospital level	0.796	0.037	0.21	21.549	0
地区Region	-0.287	0.026	-0.11	-11.237	0
是否手术Surgical procedure	-1.363	0.029	-0.471	-46.697	0
是否医保 Health insurance	0.106	0.021	0.047	5.029	0
棘球蚴病类型Type of echinococcosis	0.351	0.031	0.113	11.446	0

年度 Year	病例数 No. patient	人均GNP/元 Gross national product per capita/CNY	伤残调整寿命年 DALY		间接经济负担/万元 Indirect economic burden/10 000 CNY
年度 Year	病例数 No. patient	人均GNP/元 Gross national product per capita/CNY	人均 Per Capita	合计 Total	人均 Per Capita	合计 Total
2014	594	46 971	1.7	1 008.6	5.4	3 186.6
2015	580	49 684	2	1 156.3	6.7	3 901.2
2016	635	53 516	2.1	1 314.6	7.3	4 667.1
2017	865	59 514	1.7	1 478.8	6.7	5 801.1
2018	624	65 246	1.8	1 107.0	7.6	4 726.6
2019	604	69 881	1.7	1 020.7	7.5	4 515.4
2020	334	71 253	1.8	607.0	7.8	2 588.9
2021	357	80 803	2.0	725.7	11.1	3 953.8
2022	230	84 579	2.8	36.3	1.6	3 682.3
2023	361	88 607	2.6	952.4	1.6	5 725.3
合计	5 184	60 716	2.0	10 007.3	8.2	42 382.3