OBJECTIVES: To investigate the characteristics and medical service utilization of long-term hospitalization patients in China.

METHODS: A retrospective observational study was conducted based on China Health Insurance Research Association (CHIRA) database in 2016. The age group, disease distribution, healthcare institution level and cost structure of long-term hospitalization patients (length of stay≥30 days) were described among patients with Urban Employee/ Residents Basic Medical Insurance (UEBMI/URBMI).

RESULTS: Long-term hospitalizations (LTHs) took 4% in all the hospitalizations. 14% of the direct medical costs of the whole hospitalizations were spent on the LTHs. 63% of the LTHs were distributed in patients whose age were ≥60 years old in UEBMI group. And for URBMI patients, the percentage of patients older than 60 was 36% and the LTHs in the age range between 40 and 60 were significantly more than that in the other group. Mental disorders, cerebrovascular diseases and renal failures were the top 3 disease categories. Majority of the LTHs were concentrated in the secondary and tertiary hospitals and correspondingly, less than 20% of the LTHs occurred in the primary care institutions. In terms of cost composition, diagnosis & treatment costs were the main component of the total costs in both groups (54%, 58%) following by medication costs (36%, 32%) and medical devices & materials costs (both 10%). As for hospitalizations beyond 180 days of stay, diagnosis & treatment costs were higher (67%, 78%).

CONCLUSIONS: The middle-aged and elderly patients and those with some specific diseases should to be paid more attention in the case of long-term hospitalizations management. The long-term hospitalizations are not well-distributed in different levels of healthcare institution. For long-term hospitalizations, the longer the los of stay, the higher weight of diagnosis & treatment costs in the total costs it will be.