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

Abstract

The steady growth of pharmaceutical expenditures is a major concern for health policy makers and health care managers in Malaysia. Our study examined the factors affecting the total inpatient pharmacy cost (TINPC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). In this retrospective study, we used 2011 administration electronic prescriptions records and casemix databases at UKMMC to examine the impact of sociodemographic, diagnostic, and drug variables on the TINPC. Bivariate and multivariate analyses of the factors associated with TINPC were conducted. The mean inpatient pharmacy cost per patient was USD 102.07 (SD = 24.76). In the multivariate analysis, length of stay (LOS; B = 0.349, P < .0005) and severity level III (B = 0.253, P < .0005) were the primary factors affecting the TINPC. For each day increase in the LOS and each increase of a case of severity level III, there was an increase of approximately USD 11.97 and USD 171.53 in the TINPC per year, respectively. Moreover, the number of prescribed items of drugs and supplies was positively associated with the TINPC (B = 0.081, P < .0005). Gender appears to have affected the TINPC; male patients seem to be associated with a higher TINPC than females (mean = 139.55, 95% confidence interval [CI]: 112.97-166.13, P < .001). Surgical procedures were associated with higher cost than medical cases (mean = 87.93, 95% CI: 61.00-114.85, P < .001). Malay (MYR 242.02, SD = 65.37) and Chinese (MYR 214.66, SD = 27.99) ethnicities contributed to a lower TINPC compared with Indian (MYR 613.93, SD = 98.41) and other ethnicities (MYR 578.47, SD = 144.51). A longer hospitalization period accompanied by major complications and comorbidities had the greatest influence on the TINPC.

Determining the Cost and Length of Stay at Intensive Care Units and the Factors Influencing Them in a Teaching Hospital in Malaysia

“…In the MYDRG system, patients are classified into 3 severity levels: severity level I (no complications or comorbidities), severity level II (minor complications or comorbidities), and severity level III (major complications or comorbidities). 13 Following the algorithm, the grouper software determines the severity level based on the secondary diagnoses and procedures using ICD10 and ICD 9-CM. Patients with incomplete information, those with unavailable charts because they were admitted to private wards, and nongroupable cases were excluded from the study.…”

DRG-based payment system and management accounting changes in an Indonesian public hospital: exploring potential roles of big data analytics

“…Chaikledkaew et al (2008) suggested that patient age and sex are determinants of health-care costs and hospitalisation probability. Ariwardani et al (2019) discovered that patient age is one of the causes of differences in DRG rates and hospital costs in Indonesia, while Aljunid and Jadoo (2018) found that total inpatient pharmacy costs in a Malaysian University Hospital were determined by patient gender. More recently, Xu et al (2020) discovered that age has a positive association with hospitalization cost of patients in Chinese Naval hospitals.…”

“…Compared to other industries, where big data has been used intensively and optimally for forecasting costs, a limited application of BDA in hospitals has been noted (Qing and Liu, 2019). Prior studies have defined determinants of patient costs and their variation with DRG rates using machine learning tools (for instance, Aljunid and Jadoo, 2018;Nelson-Williams et al, 2016;Wu et al, 2020;Kuo et al, 2018).Testing mathematical models to predict cost recovery of DRG, this study also explores the potential roles of BDA in the acceleration of MACs in the hospital.…”

Covid-19 in Iraq: an estimated cost to treat patients at a private clinic

“…The average cost for a patient treated from Coronavirus in a range of five to ten days is approximately (IQD 573,228) (equivalent to USD 477.69, exchange rate 1 US Dollar (USD)= Iraqi Dinar (IQD)1200 in November 2020 ). The cost is directly proportional to the period of treatment and the emergence of complications [11].…”

“…The need to reform the Iraqi health system has become an urgent necessity through the implementation of effective health economic policies, such as the adoption of universal health insurance (UHI). Moreover, technical, and clinical systems such as the Diagnosis Related Group (DRG) or Case-mix are preferable systems that precisely detect the allocated cost per service and patient cost estimation [11,12].…”