Retrospective study estimates direct inpatient costs of peptic ulcer disease at Vietnamese military hospital

A retrospective cost-of-illness study at Military Hospital 175 in Ho Chi Minh City estimated that treating 1,985 inpatients with peptic ulcer disease from 2017 through 2022 cost USD 4.14 million in 2024-adjusted dollars, or USD 2,086.70 per patient. The estimate covered direct medical costs and selected direct non-medical costs from the healthcare provider perspective.

Researchers analyzed electronic hospital records for patients with peptic ulcer disease identified by International Classification of Diseases, 10th Revision codes K25 through K29. The study used a prevalence-based, person-based approach because peptic ulcer disease is chronic and cure could not be assumed during the observation period. Costs included examinations, laboratory and imaging tests, functional investigations, medicines and infusions, hospital beds, blood, surgery, medical supplies, and selected non-medical expenses such as food and beverages.

All monetary amounts were initially recorded in Vietnamese dong. Annual costs were adjusted to 2024 using the consumer price index and converted to US dollars at the State Bank of Vietnam’s average exchange rate of VND 24,260 per USD. Patients transferred from gastroenterology to another department and those with incomplete records were excluded. Names, telephone numbers, addresses, and other identifiers had been anonymized before the research team received the data.

Patients’ mean age was 51.7 years, with a standard deviation of 17.4. The largest age groups were 30–54 years, representing 38.8% of the cohort, and 55–70 years, representing 35.2%. Mean hospital stay was 10.6 days, with a range of one to 63 days. Gastric ulcer was the most common diagnosis, while 79.3% of patients had at least one comorbidity. Half of the cohort resided in Ho Chi Minh City and 46.5% lived in other provinces.

Medical supplies were the largest component of the estimated cost, totaling USD 2,054,049, or 49.6% of the six-year total. Medicines and infusions accounted for USD 729,242, or 17.6%; hospital bed fees for USD 518,245, or 12.5%; surgery for USD 402,911, or 9.7%; laboratory tests for USD 257,241, or 6.2%; and diagnostic imaging for USD 129,338, or 3.1%. The share attributed to medical supplies was 1.6–29.4% during 2017–2020 before rising to 41.35% in 2021 and 65.3% in 2022.

Average cost per patient was USD 387.20 in 2017, USD 793.10 in 2018, USD 681.10 in 2019, USD 1,485.90 in 2020, USD 1,810.50 in 2021, and USD 3,784.30 in 2022. Annual numbers of included patients also varied, from 79 in 2017 to 601 in 2022, so the retrospective estimates do not establish that costs per admission alone caused the overall increase. The authors associated the late-period cost shift with more severe complications and comorbidities, which may have required more surgery, supplies, injections, and infusions.

Men accounted for USD 2,352,844, or 56.8%, of total costs, compared with USD 1,789,277, or 43.2%, for women; the Mann–Whitney U test showed a statistically significant difference in treatment costs between the groups. Civilian patients accounted for USD 3,906,872, or 94.3%, while military personnel accounted for USD 235,249, or 5.7%, with a significant difference between the groups. Patients with comorbidities generated USD 3,940,121, or 95.1%, of total costs, compared with USD 202,000, or 4.9%, for those without comorbidities.

Medicines specifically identified for peptic ulcer treatment totaled USD 88,640. Proton pump inhibitors represented 90.7% of that amount, or USD 80,350, with pantoprazole accounting for 64.5% of PPI costs and esomeprazole for 28.26%. Antibiotics represented 7.0%, mucosal protective agents 1.4%, and histamine-2 receptor antagonists 0.9%. In the sensitivity analysis, a hypothetical 10% reduction in medical-supply costs would lower total direct medical costs by 5.0%, compared with 1.8% for medicines and infusions, 1.3% for hospital beds, 0.97% for surgery, 0.6% for laboratory tests, and 0.3% for diagnostic imaging.

The findings have important boundaries. The study covered one final-tier military hospital that also provides insured and public services, rather than a nationally representative sample of Vietnamese patients with peptic ulcer disease. It estimated direct medical costs and part of the direct non-medical burden but did not include travel, accommodation for caregivers, lost income, or other indirect costs. The analysis also recorded only whether comorbidities were present, not their type or severity. Although the study was described as a cost-of-illness assessment rather than a clinical-effectiveness trial, its detailed service-level estimates provide a bounded measure of the direct resources used for inpatient peptic ulcer disease care at that hospital.

Subject of Research: Retrospective estimation of direct inpatient costs for peptic ulcer disease in a Vietnamese military hospital

Article Title: Analysis of direct medical costs for the treatment of peptic ulcer disease in inpatients at a military hospital: a retrospective study in Vietnam

Article References: Ong, T. D., Tran, V.-Q., Nguyen, P. N. M., Nguyen, H. M., Phan, N. M., Vo, B. V., Nguyen, T. D., & Vo, T. Q. (2026). Analysis of direct medical costs for the treatment of peptic ulcer disease in inpatients at a military hospital: a retrospective study in Vietnam. Pharmacia, 73, Article e201763. https://doi.org/10.3897/pharmacia.73.e201763

Image Credits: AI Generated

DOI: 10.3897/pharmacia.73.e201763

Keywords: peptic ulcer disease, Vietnam, cost-of-illness, retrospective study, hospital costs, medical supplies, military hospital, health economics, Analysis, direct, medical, costs