Adjusted relative weight, Medical expense, Reimbursement and Medical cost outcomes for patients transferred from regional hospitals to community hospitals in Sisaket Province
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Abstract
The transfer of hospitalized patients from regional hospitals to community hospitals is essential for resource management in the healthcare system. Objectives: To analyze adjusted relative weight, medical expense, reimbursement and medical cost outcomes for patients treated at community hospitals, with or without referral for injectable antibacterial drugs from regional hospitals. Methods: This descriptive study analyzed data from October 2022 to September 2023. The sample was divided into two groups: one receiving intravenous antibiotics from regional hospitals and the other receiving from community hospitals. The Mann-Whitney U-test was applied to determine statistical significance. Results: There were 522 (23.97%) cases of patients receiving injectable antimicrobial drugs at regional hospitals. Most patients were male 1,385 (63.59%). A total referred to community hospitals for treatment at Khunhan Hospital, Khukhan Hospital, and Kanthararom Hospital, which were the top three referring hospitals. The overall adjusted relative weight was 3.21, medical expense of 41,334.75 THB, reimbursement of 27,867.63 THB, and medical cost outcomes of -13,467.13 THB. Adjusted relative weight, medical expense, reimbursement for injectable antimicrobial drugs was higher in regional hospitals than in community hospitals (p-value< 0.001). However, the medical cost outcome of injectable antimicrobial drugs in regional hospitals was lower than in community hospitals (p-value <0.001). Transferred patients had a total medical expense amount of 90,027,098.20 THB, with a total reimbursement of 60,695,692.22 THB, leading to a financial loss of 29,331,405.98 THB for hospitals. The top three disease groups contributing to financial losses were digestive system diseases, infectious and parasitic diseases, and injuries, poisoning, and certain other consequences of external causes, respectively. Conclusion: Patients who were transferred from regional hospitals to community hospitals and received medicine from the regional hospital had higher adjusted relative weight, medical expense, reimbursement. However, when looking at the final medical cost outcomes, they lost more money compared to those who did not receive medicine from the regional hospital.
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