Factors predicting hospital financial risks associated with stroke treatment under a Diagnosis-Related Group payment

Authors

  • Hirunrassamee S Pharmacy Practice and Management Research Unit, Faculty of Pharmacy, Thammasat University
  • Maluangnon K Pharmacy Practice and Management Research Unit, Faculty of Pharmacy, Thammasat University
  • Sooksriwong C Pharmacy Practice and Management Research Unit, Faculty of Pharmacy, Thammasat University
  • Keetawattanakul P Pharmacy Division, Pharmongkutklao Hospital
  • Loessaksrisakul N Pharmacy Division, Faculty of Medicine Ramathibodi Hospital, Mahidol University

Keywords:

stroke, hospital cost, diagnosis related groups, financial risks

Abstract

Objectives The aim of this study is to determine the factors that influence stroke hospitalization costs for financially high-risk groups under the DRG payment method.

Methods A retrospective study was conducted with stroke inpatients at Phramongkutklao Hospital. Data was collected from an administrative database and electronic medical records. Multiple regression analysis was performed to determine the association between hospital costs and factors that influence those costs in terms of a correlation coefficient for a financially high-risk group.

Results The results indicate that among 272 stroke patients, 57.0% were male with a mean age of 69.2 ± 14.2 years. The median charge per admission was 52,854 (IQR : 25,434, 147,229) THB and median charge per length of stay (LOS) was 5,065 (IQR : 3,347, 7,738) THB. Multiple regression analysis among 13 factors found that having surgery, use of a ventilator, prolonged LOS, and insurance type had significant correlations with stroke hospital costs (R-square = 0.83, p < 0.05).

Conclusions In conclusion, surgery, use of a ventilator, and LOS, insurance type are clinical factors that are associated with significant increased costs for financially high-risk groups.

Downloads

Download data is not yet available.

References

1. Ministry of Public Health, Department of Medical Services. Thailand Medical Services Profile 2015-2018. Nonthaburi: Department of Medical Services; 2018. (in Thai)
2. Ministry of Public Health, Department of Medical Services. Literature Review: The current situation and care model of non-communicable diseases. Nonthaburi: Institute of Medical Research and Technology Assessment; 2018. (in Thai)
3. Namfon S, Arthorn R, Usa C, John FS, Tassante T, Suchat H. Cost of acute care for Ischemic stroke in Thailand. Southeast Asian J trop Med Public Health. 2017;3:628-40
4. Ng CS, Toh MP, Ng J, Ko Y. Direct medical cost of stroke in Singapore. Int J Stroke. 2015;10: 75-82.
5. Huang Y, Hu C, Lee T, Yang J, Weng H, Lin L et al. The impact factors on the cost and length of stay among acute ischemic stroke. J Stroke Cerebrovasc Dis. 2013;22:e152-8.
6. Brüggenjürgen B, Rossnagel K, Roll S, Andersson F, Selim D, Müller-Nordhorn J, et al. The impact of atrial fibrillation on the cost of stroke: the Berlin acute stroke study. Value Health. 2007;10:137-43.
7. Phakdiphan S, Anantachoti P, Pengsupap T, Trakunkan S. Hospital financial status and quality of care under diagnosis related groups payment mechanism. Thai Pharmaceutical and Health Science J. 2014;9:213-21. (in Thai)
8. Ratanawijitrasin S. Health Insurance: an In-depth Guide. Bangkok: Chulalongkorn University Press; 2005. (in Thai)
9. Kanokwongnuwat P. Model of hospital management on breakthrough financial crisis. J Prapokklao Hosp Clin Med Educat Center. 2013;30:106-22. (in Thai)
10. Srinukum S, Pannjean V, Raknam T, Watthanakool Y. Study on Summary of Discharge Diagnosis (ICD-10 and ICD-9 CM) and Hospital Fee Reimbursement Based on Diagnosis Related Group System at Hospital for Tropical Diseases: Study on Summary of Discharge Diagnosis (ICD-10 and ICD-9 CM) and Hospital Fee Reimbursement Based on Diagnosis Related Group System at Hospital for Tropical Diseases. Int Soc Sci J. [Internet]. 2018 Sep. 17 [cited 2021 Jul.11];1:125-43. Available from: https://so02.tci-thaijo.org/index.php/isshmu/article/view/145985 (in Thai)
11. Laloux P. Belgian Stroke Council. Cost of acute stroke. A review. Acta Neurol Belg. 2003; 103:71-7.
12. Sussman M, Menzin J, Lin I, Kwong WJ, Munsell M, Friedman M, et al. Impact of atrial fibrillation on stroke-related healthcare costs. J Am Heart Assoc. 2013;2:e000479.
13. Blackwood B, Alderdice F, Burns K, Cardwell C, Lavery G. O’Halloran P. Use of weaning protocols for reducing duration of mechanical ventilation in critically ill adult patients: Cochrane systematic review and meta-analysis. BMJ. 2011;342:c7237-7.

Published

2021-10-01

How to Cite

1.
S H, K M, C S, P K, N L. Factors predicting hospital financial risks associated with stroke treatment under a Diagnosis-Related Group payment. Chiang Mai Med J. [Internet]. 2021 Oct. 1 [cited 2022 May 25];60(4):587-98. Available from: https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/253941

Issue

Section

Original Article