Analysis of Factors Influencing Avoidable Hospitalization Costs for Stable Angina Pectoris in Liaoning Province

Su Tong; Zhang Jingying; Wang Guilin; Zheng Fengchun; Ma Yuedan

Abstract：Objective:To provide evidence-based support and policy recommendations for improving the prevention and management of stable angina pectoris(SAP)within the current government chronic disease control system,based on the theory of Ambulatory Care Sensitive Conditions(ACSCs).Methods:A total of 104 066 hospitalized cases of angina pectoris were included.Using the SHA 2011 framework for total health expenditure analysis,factors influencing avoidable hospitalization for SAP were identified.Multivariable logistic regression analysis was conducted to examine the associations between these factors and hospitalization costs for SAP.Results:Avoidable hospitalizations were predominantly concentrated in tertiary hospitals(82.01％),where hospitalization costs were significantly higher than those in primary healthcare institutions.Multivariable logistic regression analysis revealed that insurance type had a significant effect on hospitalization costs,and patients treated in tertiary hospitals were more likely to incur high medical expenses.Conclusions:The current SAP prevention and treatment system faces challenges such as insufficient capacity of primary healthcare,resource concentration in tertiary hospitals,and the impact of medical insurance policies on hospital choice.It is recommended to strengthen primary healthcare services and include SAP in chronic disease management programs to reduce unnecessary hospitalizations.Additionally,expanding insurance coverage could help reduce the risk of catastrophic health expenditure among self-paying patients.