Analysis of hospitalization of people with hemophilia—12 years of experience in a single center

Background To what extent hospital use and medical resources are used on hemophilia care in China's health care system is unknown. Objectives This study was based on a single center in China and was conducted to comprehensively assess the resource use for hospitalization of people with hemophilia. Methods We analyzed clinical characteristics, diagnosis, inhibitor status, reasons, length of stay, and hospital costs of 323 hospitalizations in which hemophilia must be considered as the main factor for hospitalization from January 2009 to December 2020 at the Institute of Hematology and Blood Diseases Hospital in Tianjin, China. Results There were 265 hospitalizations for people with hemophilia A (HA) and 58 with hemophilia B (HB). Seventy-eight hospitalizations (24%) were for patients with inhibitor (INH+). Minor bleeding (eg, hemarthrosis, hematuria) was the most common reason for hospitalization. The cost of clotting factor concentrates was the major burden of inpatients with hemophilia. Total cost in a single hospitalization of a person with HA (median, 21,281 Chinese yuan [ yen ]) was about twice that for HB (median, yen 11,060). Expenditure of drugs in HA (median yen 14,157) was two to three times more than that in HB (median, yen 5707). Total cost and drug cost in hospitalizations of people with inhibitors were about two times more than these without (INH-) (median cost in INH+ hospitalizations: total cost, yen 27,303; drug cost, yen 20,445. Median cost in INH- hospitalizations: total cost, yen 17,743; drug cost, yen 11,973.). Conclusions For hemophilia, the most dominant cost during hospitalization was on clotting factor concentrates. Diagnosed HA and inhibitor positivity increased the global cost.