Development of MY-DRG casemix pharmacy service weights in UKM Medical Centre in Malaysia

Abstract

BackgroundThe service weight is among several issues and challenges in the implementation of case-mix in developing countries, including Malaysia. The aim of this study is to develop the Malaysian Diagnosis Related Group (MY-DRG) case-mix pharmacy service weight in University Kebangsaan Malaysia-Medical Center (UKMMC) by identifying the actual cost of pharmacy services by MY-DRG groups in the hospital.MethodsAll patients admitted to UKMMC in 2011 were recruited in this study. Combination of Step-down and Bottom-up costing methodology has been used in this study. The drug and supplies cost; the cost of staff; the overhead cost; and the equipment cost make up the four components of pharmacy. Direct costing approach has been employed to calculate Drugs and supplies cost from electronic-prescription system; and the inpatient pharmacy staff cost, while the overhead cost and the pharmacy equipments cost have been calculated indirectly from MY-DRG data base. The total pharmacy cost was obtained by summing the four pharmacy components’ cost per each MY-DRG. The Pharmacy service weight of a MY-DRG was estimated by dividing the average pharmacy cost of the investigated MY-DRG on the average of a specified MY-DRG (which usually the average pharmacy cost of all MY-DRGs).ResultsDrugs and supplies were the main component (86.0%) of pharmacy cost compared o overhead cost centers (7.3%), staff cost (6.5%) and pharmacy equipments (0.2%) respectively. Out of 789 inpatient MY-DRGs case-mix groups, 450 (57.0%) groups were utilized by the UKMMC. Pharmacy service weight has been calculated for each of these 450 MY-DRGs groups. MY-DRG case-mix group of Lymphoma & Chronic Leukemia group with severity level three (C-4-11-III) has the highest pharmacy service weight of 11.8 equivalents to average pharmacy cost of RM 5383.90. While the MY-DRG case-mix group for Circumcision with severity level one (V-1-15-I) has the lowest pharmacy service weight of 0.04 equivalents to average pharmacy cost of RM 17.83.ConclusionA mixed approach which is based partly on top-down and partly on bottom up costing methodology has been recruited to develop MY-DRG case-mix pharmacy service weight for 450 groups utilized by the UKMMC in 2011.

Costing Information System Design for a Clinic Registered as a First-Degree Healthcare Provider (Case Study: Ismal Medika Health Clinic)

“…Bottom-up costing records every item of service that a patient receives, and changes them into costs. Bottom-up costing gives more accurate results, but it requires a large investment of time and resources (Jadoo et al, 2015). Time-driven activity-based costing (TDABC) by Kaplan and Porter (2011) gives accurate cost information but it requires a lot of detailed data, e.g., time spent by doctors with patient and time spent by administration staff to serve patients.…”

The development of inpatient cost and nursing service weights in a tertiary hospital in Malaysia

“…For instance, the output of a study on cost weights for treatment of cardiology showed that the range of cost weights was between 0.4710 and 0.7961, while the cost weights for orthopaedic cases were between 0.7438 and 1.8182 [25]. A study done by Ali Jadoo et al to determine the service weights for pharmacy showed that the range of pharmacy service weights was between 3.78 and 11.80 [26]. In a recent study by Roszita on the laboratory and radiology service weights, the laboratory service weights was between 1.6896 and 5.9609, while radiology service weights was between 1.6336 and 2.8461 [27].…”

Factors Influencing the Total Inpatient Pharmacy Cost at a Tertiary Hospital in Malaysia: A Retrospective Study

“…1 The need for cost and pharmacoeconomics evaluations is well acknowledged. [2][3][4][5][6] In terms of health-policy comparatives and analytic techniques, health economic studies provide important and valuable information that enables health care decision makers to adjust and effectively use of pharmaceuticals. 3 In this article, we used normal linear specifications to test a number of factors (eg, sociodemographic, diagnostic, and drug data) that are thought to impact the total inpatient pharmacy cost (TINPC), and we compared our results with others from literature.…”

“…IPD captures the details of specific patient (depending on the data source) and serves as a potential tool to analyze pharmaceutical cost. 4 However, many countries including Malaysia are hindered by the lack of the availability of detailed illness costs at IPD, which can reflect negatively on 755483I NQXXX10.1177/0046958018755483INQUIRY: The Journal of Health Care Organization, Provision, and FinancingAljunid and Ali Jadoo research-article2018 1 Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia 2 Faculty of Public Health, Kuwait University, Kuwait the health economic analysis relevant to the local health care system. The National University of Malaysia Medical Center (UKMMC) was a pioneer that adopted and developed its own casemix and Malaysian Diagnosis-Related Groups (MY-DRGs) system in 2002.…”