Cost of elective percutaneous coronary intervention in Malaysia: a multicentre cross-sectional costing study

Lee, Kun Yun; Ong, Tiong Kiam; Low, Ee Vien; Liow, Siow Yen; Anchah, Lawrence; Hamzah, Syuhada; Liew, Houng Bang; Ali, Rosli Mohd; Ismail, Omar; Ahmad, Wan Azman Wan; Said, Mas Ayu; Dahlui, Maznah

doi:10.1136/bmjopen-2016-014307

Cited by 10 publications

(11 citation statements)

References 20 publications

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“…A systematic review by Lesyuk et al found that inpatient admission cost accounted for about 44% to 96% of the overall direct cost of HF ( 9 ). Annual inpatient cost was also the main cost driver of HF in the current study, which was in line with other studies ( 19 , 29 , 40 , 46 ).…”

Section: Discussionsupporting

confidence: 92%

“…The unit cost of utilised drugs was valued based on the national price list of medicines provided by the Pharmacy Department’s Procurement Unit, using the hospital pharmacy’s average acquisition costs. Additionally, the cost of the percutaneous coronary intervention (PCI) was obtained from a published work in estimating the cost of PCI in five cardiac centres in Malaysia ( 19 ). All costs were converted to the 2021 values using the Malaysian consumer price index for the health domain ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

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Cost analysis of chronic heart failure management in Malaysia: A multi-centred retrospective study

Ong

Low²,

Yew³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundEstimation of the economic burden of heart failure (HF) through a complete evaluation is essential for improved treatment planning in the future. This estimation also helps in reimbursement decisions for newer HF treatments. This study aims to estimate the cost of HF treatment in Malaysia from the Ministry of Health’s perspective.Materials and methodsA prevalence-based, bottom-up cost analysis study was conducted in three tertiary hospitals in Malaysia. Chronic HF patients who received treatment between 1 January 2016 and 31 December 2018 were included in the study. The direct cost of HF was estimated from the patients’ healthcare resource utilisation throughout a one-year follow-up period extracted from patients’ medical records. The total costs consisted of outpatient, hospitalisation, medications, laboratory tests and procedure costs, categorised according to ejection fraction (EF) and the New York Heart Association (NYHA) functional classification.ResultsA total of 329 patients were included in the study. The mean ± standard deviation of total cost per HF patient per-year (PPPY) was USD 1,971 ± USD 1,255, of which inpatient cost accounted for 74.7% of the total cost. Medication costs (42.0%) and procedure cost (40.8%) contributed to the largest proportion of outpatient and inpatient costs. HF patients with preserved EF had the highest mean total cost of PPPY, at USD 2,410 ± USD 1,226. The mean cost PPPY of NYHA class II was USD 2,044 ± USD 1,528, the highest among all the functional classes. Patients with underlying coronary artery disease had the highest mean total cost, at USD 2,438 ± USD 1,456, compared to other comorbidities. HF patients receiving angiotensin-receptor neprilysin-inhibitor (ARNi) had significantly higher total cost of HF PPPY in comparison to patients without ARNi consumption (USD 2,439 vs. USD 1,933, p < 0.001). Hospitalisation, percutaneous coronary intervention, coronary angiogram, and comorbidities were the cost predictors of HF.ConclusionInpatient cost was the main driver of healthcare cost for HF. Efficient strategies for preventing HF-related hospitalisation and improving HF management may potentially reduce the healthcare cost for HF treatment in Malaysia.

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Cost analysis of chronic heart failure management in Malaysia: A multi-centred retrospective study

Ong

Low²,

Yew³

et al. 2022

Front. Cardiovasc. Med.

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“…There are many PH implications derived from the findings of this study. On the government side, it provides evidence on cost-effectiveness of PCIs and how prioritization of budget and allocation of personnel should be made (Lee, Ong, et al, 2017). These are important to maintain an equitable basis for financing health services in the face of escalating health care cost.…”

Section: Analysis and Discussionmentioning

confidence: 99%

Economic Evaluation for Health Advocacy and Informed Policy

Dahlui

Rochmah

Ernawaty

et al. 2021

JAKI

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Background: Healthcare resources are limited therefore, adequate, appropriate and timely allocation of resources are important. Decision to invest on health care program can be made from the analysis of the information obtained on the cost and consequences of the various alternative health programs, often known as economic evaluation of health interventions.Aims: This write-up emphasizes on the importance of evidence driven policy of health intervention whereby economic evaluation should be performed to indicate whether investment on health intervention would benefit the country.Methods: Literature review on economic evaluation studies conducted by the first author during her 14 years tenure as academician had been performed. Various studies which applied the cost-effectiveness analysis tools to economically evaluate health interventions and programs in Malaysia and other countries are shared.Results: The economic evaluation studies cut across different programs such as disease prevention and treatment, public health monitoring and control, and implications of health issues to the healthcare system. Many of the findings have been used for advocacy to shape the delivery of more effective health intervention programs in the country.Conclusion: The country will benefit from economic evaluation studies which could provide evidence to assist in policy making on health programs for the country.Keywords: economic evaluation, health programs, policy making

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“…Using top-down approach, these costs were identified and valuated. A detailed description of the derivation and calculation of these cost items was outlined in a previous study [ 14 ]. A fully top-down costing approach only produced an average estimate of PCI hospitalization per patient.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study

et al. 2017

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IntroductionThe increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH) and a general hospital (GH).MethodsThis cross-sectional study was conducted from the healthcare providers’ perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test.ResultsThe mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients’ comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost.ConclusionsThe high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and equitable cardiac service in Malaysia.

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Cost of elective percutaneous coronary intervention in Malaysia: a multicentre cross-sectional costing study

Cited by 10 publications

References 20 publications

Cost analysis of chronic heart failure management in Malaysia: A multi-centred retrospective study

Cost analysis of chronic heart failure management in Malaysia: A multi-centred retrospective study

Economic Evaluation for Health Advocacy and Informed Policy

Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study

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