Abstract: Objective To investigate the hospitalization cost and influencing factors of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) in Beijing Youan Hospital to provide a reference basis for rational control of patients' hospitalization cost. Methods The data on the first page of 1247 patients hospitalized with a primary diagnosis of HBV-ACLF in our hospital from 2012-2021 were collected. After excluding the influence of price factors, the changing trend and influencing factors of hospitalization costs were analyzed. Mann-Kendall trend test was used to analyze the changes of hospitalization costs with years, and single-factor and multi-factor linear regression methods were used to analyze the influencing factors of hospitalization costs. Results During the decade of 2012-2021, the average hospitalization cost of patients with HBV-ACLF fluctuated from 55373.04 to 62921.70 yuan, and the average daily cost fluctuated from 2,676.42 to 3,172.17 yuan, with no significant change with year, and none of the trend analysis was statistically significant (P<0.05). The cost of medicine always occupied the first place in the composition of hospitalization costs of HBV-ACLF patients (37.7%-64.1%), but showed a decreasing trend with the year, followed by the examination fee (13.7%-18.5%), which showed an increasing trend with the year. Although treatment fees, surgery fees and blood transfusion fees did not account for a high proportion, they also showed an increasing trend with the year, and all trend analyses were statistically significant (P<0.05). Through univariate and multivariate linear regression analysis, the main factors affecting the hospitalization costs of HBV-ACLF patients were hospitalization days (β=0.683, P=0.000) and gender (β=-0.059, P=0.007). The longer the hospitalization days, the higher the hospitalization costs, and the hospitalization costs of male patients were higher than those of female patients. Conclusion The hospitalization cost of HBV-ACLF patients is high which results in the heavy the economic burden. Strengthening the health education of hepatitis B patients, optimizing the hospitalization costs structure, and reasonably shortening the hospitalization time are helpful to reduce the economic burden of HBV-ACLF patients.

Key words: Hepatitis B virus, Liver failure, Hospitalization costs, Influence factors