ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
This article is part of the Research TopicInnovative Value-Based Medicine: Lessons from China's Healthcare EvolutionView all 17 articles
Characteristics of Hospitalization Patterns and Expenditures in Cross-border Medical Tourism: A Knee Replacement Surgery Cohort Study
Provisionally accepted
Shiya Zuo1*
Ling Lin2*- 1Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
- 2The University of Hong Kong-Shenzhen Hospita, Shenzhen, China
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Objective: Using knee arthroplasty as a case study, this research explores the characteristics of length of stay (LOS) and hospitalization costs for Hong Kong residents receiving medical treatment in mainland China. Methods: Utilizing front-page medical record data of patients who underwent knee arthroplasty at Hospital H, descriptive statistics, univariate analysis, and mediation effect tests were conducted to analyze the impact of being a Hong Kong patient on LOS and hospitalization costs. Results: The study included 356 patients, predominantly elderly over 65 years old (77.25%), with a similar gender distribution. Hong Kong patients had shorter LOS, shorter postoperative LOS, and lower hospitalization costs, laboratory and examination costs, and medication costs. LOS fully mediated the effect of being a Hong Kong patient on hospitalization costs. Conclusion: Hong Kong residents seeking medical care in mainland China are driven by factors distinct from those of non-local patients within mainland China, with medical quality, efficiency, and cost being significant drivers of cross-border healthcare seeking. It is essential to strengthen cross-border medical collaboration between Shenzhen and Hong Kong, and the Greater Bay Area as a whole, through institutional mechanisms, welfare benefits, long-term follow-up, and health monitoring to ensure tangible medical benefits for Hong Kong patients.
Keywords: Seeking medical care in mainland China, Cross-border medical cooperation, knee arthroplasty, Length of Stay, Hospitalization costs
Received: 27 Jun 2025; Accepted: 26 Nov 2025.
Copyright: © 2025 Zuo and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shiya Zuo
Ling Lin
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