{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:00:14Z","timestamp":1788382814450,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["NSFC82360422"],"award-info":[{"award-number":["NSFC82360422"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ankylosing spondylitis (AS) is a chronic inflammatory disorder that imposes a significant economic burden through high healthcare costs. Prior studies have explored AS\u2010related expenditures, but a comprehensive analysis of cost\u2010related factors is lacking. This study aims to fill this gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from 6149 AS patients (2018\u20132024) at two tertiary hospitals in Guangxi, China, and classified them as surgical or non\u2010surgical; inpatients were categorized by catastrophic health expenditures (CHE; &gt;\u200950% of household income). Descriptive statistics and the Kruskal\u2013Wallis test were used to assess patient characteristics and cost differences, whereas propensity score matching and multivariable logistic regression were used to identify independent CHE predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 6149 AS patients were included. Surgical patients were older and incurred significantly higher inpatient costs (USD 9457.21 vs. USD 1177.10 for non\u2010surgical patients). General medical service costs, imaging examination costs, Western medicine costs, and medical supply costs are risk factors affecting CHE in hospitalized patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      imposes a substantial economic burden, particularly on surgical patients. Key cost drivers, including general medical services, imaging, pharmaceuticals, and medical supplies, markedly increase the risk of catastrophic expenditures. Implementing policy reforms to enhance insurance coverage, alongside clinical cost\u2010control strategies such as rational imaging use, adoption of generic medicines, and optimized management of medical supplies, is essential to alleviate financial strain and improve the sustainability of\n                      <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                      care.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.70449","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T22:48:08Z","timestamp":1762382888000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comprehensive Economic Analysis of Healthcare Costs in Ankylosing Spondylitis: Treatment Strategies and Socioeconomic Implications"],"prefix":"10.1111","volume":"28","author":[{"given":"Xiaopeng","family":"Qin","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuo","family":"Chen","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Ma","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Clinical Treatment Center of Guangxi (Nanning) and The Fourth People's Hospital of Nanning  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhang","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Statistics Beijing Normal University  Beijing People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongqing","family":"He","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boli","family":"Qin","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Pan","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Clinical Treatment Center of Guangxi (Nanning) and The Fourth People's Hospital of Nanning  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxing","family":"Zhou","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyou","family":"Chen","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songze","family":"Wu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiarui","family":"Chen","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang","family":"Xue","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kechang","family":"He","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Clinical Treatment Center of Guangxi (Nanning) and The Fourth People's Hospital of Nanning  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6936-481X","authenticated-orcid":false,"given":"Xinli","family":"Zhan","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2479-3001","authenticated-orcid":false,"given":"Chong","family":"Liu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10389\u2010024\u201002309\u20109"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-10828-3"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czy081"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-013-0053-6"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2013.33352"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41413-019-0057-8"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms\/146793"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/24.3.242"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2470"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207688"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-016-3336-4"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh271"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3895"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m4447"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.210909"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5724-8"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-023-02008-z"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/70.1.41"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3697"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.2806"},{"key":"e_1_2_13_22_1","article-title":"What Can We Learn From China's Health System Reform?","volume":"365","author":"Meng Q.","year":"2019","journal-title":"BMJ (Clinical Research Ed.)"},{"issue":"1","key":"e_1_2_13_23_1","first-page":"21","article-title":"Power Comparisons of Shapiro\u2010Wilk, Kolmogorov\u2010Smirnov, Lilliefors and Anderson\u2010Darling Tests","volume":"2","author":"Razali N. M.","year":"2011","journal-title":"Journal of Statistical Modeling and Analytics"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0093253"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.pan.a004868"},{"issue":"1","key":"e_1_2_13_26_1","first-page":"10","article-title":"Using the Student's t\u2010Test With Extremely Small Sample Sizes","volume":"18","author":"De Winter J. C.","year":"2019","journal-title":"Practical Assessment, Research and Evaluation"},{"key":"e_1_2_13_27_1","volume-title":"Methods for the Economic Evaluation of Health Care Programmes","author":"Drummond M. F.","year":"2015"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61880-1"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2014.003"},{"key":"e_1_2_13_30_1","first-page":"4","article-title":"The Burden of Ankylosing Spondylitis","volume":"78","author":"Boonen A.","year":"2006","journal-title":"Journal of Rheumatology Supplement"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2018.06.15"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60635-7"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1586\/14737167.2015.1001370"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.997694"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40744-020-00194-8"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2022.28.9.1008"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/lycdc8"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1209"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13861-5"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-019-1908-9"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken010"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211544"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000025998"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61483-4"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-025-08295-7"}],"container-title":["International Journal of Rheumatic Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185X.70449","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1756-185X.70449","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185X.70449","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:10:46Z","timestamp":1782123046000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1756-185X.70449"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":44,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/1756-185X.70449"],"URL":"https:\/\/doi.org\/10.1111\/1756-185x.70449","archive":["Portico"],"relation":{},"ISSN":["1756-1841","1756-185X"],"issn-type":[{"value":"1756-1841","type":"print"},{"value":"1756-185X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-02-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70449"}}