Costs of Admission to Kumphawapi Hospital in Patients with Pneumonia

Abstract

Objective: To estimate hospitalization costs of patients admitted with pneumonia to Kumphawapi Hospital, identifying factors associated with the hospitalization costs and hospital readmission within 28 days, and analyzing time trends in costs of drugs used during the hospitalization. Methods: This was a retrospective study using the Hospital’s electronic database in fiscal years 2015-2018 as data source. Costs were calculated based on the hospital perspective. Results: In the fiscal years 2015-2018, there were 3,009 hospital admissions of patients with pneumonia. The median hospitalization cost per admission was 6,497 Baht (interquartile range, 3,828-15,160 Baht). There were 1,679 admissions of patients with the Universal Coverage Scheme. Factors associated significantly with an increased cost (P<0.05) included patients aged 15-59 years or above, 60-74 years, a presence of comorbidity-complication of the diagnosis-related group at major-to-extreme level, length of stay 3 days or above, having respiratory procedures, and use of antibiotics classified as list D in the National Lists of Essential Medicines (NLEM) with a mandatory drug use evaluation.  For the odds of 28-day readmission, no factors were found with a statistically significant association. For trends in drug costs, the average growth rate was 0.32 percentage point per quarter (95% CI, 0.08-0.56). Conclusion: To reduce the costs of pneumonia hospitalization, the Hospital should vigorously implement drug use evaluation program of inpatients’ antibiotic use.