OBJECTIVES : To analyze the medical expenditures and impact factors of patients with pulmonary embolism(PE) among the population with urban basic health insurance in China in 2014.

METHODS : This retrospective analysis identified patients diagnosed with PE in 2014 in the China Health Insurance Research Association (CHIRA) claims database, which is the largest nationwide claims database in mainland China. All of the patients were included if they were aged 18 years and older and their diagnosis included PE based on the ICD-10 codes or the physician’s notes. Patients’ demographic characteristics, co-morbities, length of hospital stay and healthcare costs were also collected from the database. Descriptive statistics of demographic characteristics, co-morbidities, types of hospitals, and frequency of hospitalization were calculated. Multiple linear regression analyses was used to analyze the impact factors of patients’ annualized healthcare expenditure.

RESULTS : A total of 475 patients with PE were identified ( mean age of 65.87 ± 14.62 years, 47.2% male). And the average healthcare expense per patient was Renminbi (RMB) 10,847.42(median: RMB 4113.00, IQR: 497.68-14,379.01, in 2014 term), 40% of which were medication costs. Of all patients, 218 patients received only outpatient treatment with average healthcare expense per patient of RMB 1005.95. And 257 patients received inpatient treatment with average healthcare expense per patient of RMB 19,195.43. The healthcare expenditure were significantly associated with whether having hospitalization (yes/no), admission to a tertiary hospital, and co-morbidities ( cancer, diabetes, hypertension, surgery, chronic kidney disease and coronary heart disease).

CONCLUSIONS : The economic burden of PE patients is substantial, considering the disposable income in China (RMB 20,167 in 2014). Hospitalization seems the main driver of the total costs.