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. 2024 Aug 7;13(8):666.
doi: 10.3390/pathogens13080666.

Direct Cost Analysis of Microbial Keratitis in North China: A Hospital-Based Retrospective Study

Qingquan Shi  1 , Bo Peng  1 , Zhen Cheng  1 , Zijun Zhang  1 , Zhenyu Wei  1 , Zhiqun Wang  1 , Yang Zhang  1 , Kexin Chen  1 , Xizhan Xu  1 , Xinxin Lu  1 , Kai Cao  1 , Xueyao Wei  1 , Qingfeng Liang  1
Affiliations

Direct Cost Analysis of Microbial Keratitis in North China: A Hospital-Based Retrospective Study

Qingquan Shi et al. Pathogens. .

Abstract

Microbial keratitis (MK) is the fourth leading cause of blindness globally, imposing a substantial burden on the healthcare system. This study aims to determine the cost composition of MK patients and explore factors influencing these expenses. We analyzed the demographics, clinical features, and costs of 602 MK patients treated at Beijing Tongren Hospital from June 2021 to October 2023. The analysis revealed the average total cost of treating MK was USD 1646.8, with a median of USD 550.3 (IQR: 333.3-1239.1). Patients with Acanthamoeba keratitis (AK) incurred the highest median total costs at USD 706.2 (IQR: 399.2-3370.2). Additionally, AK patients faced the highest costs for ophthalmic exams and laboratory tests (both p < 0.001), while patients with fungal keratitis (FK) and viral keratitis (VK) experienced higher medication costs. Costs varied significantly with the severity of MK, especially for outpatients at severity level 4, which was markedly higher than levels 1-3 (USD 1520.1 vs. USD 401.0, p < 0.001). Delayed presentation also resulted in increased costs (USD 385.2 vs. USD 600.3, p < 0.001). Our study highlights the financial burden associated with MK treatment and underscores the importance of timely and accurate diagnosis and intervention.

Keywords: China; corneal ulcer; economic burden; healthcare cost; microbial keratitis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Median costs of patients with different types of keratitis. (A) Among outpatient visits; (B) among inpatient visits; (C) comparative analysis of costs for outpatients with different types of keratitis across different cost types. BK, Bacterial Keratitis; FK, Fungal Keratitis; VK, Viral Keratitis; AK, Acanthamoeba Keratitis; MMK, Mixed Microbial Keratitis. ** represents 0.001 < p < 0.01, *** represents p < 0.001.
Figure 2
Figure 2
Comparative analysis of different types of costs based on the various influencing factors including gender, age, time to presentation, diabetes, and hypertension. * represents 0.01 < p < 0.05.
Figure 3
Figure 3
Association measures among demographics, clinical parameters, and cost data of Microbial Keratitis patients (points with p > 0.05 have been excluded) using Pearson’s r, Spearman’s rho, and Cramer’s V.
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