การศึกษาความเป็นไปได้และผลกระทบทางงบประมาณในการให้บริการเพทซีทีของโรงพยาบาลรัฐ 2 แห่งในประเทศไทย

Chanisa Chotipanich; Chetsadaporn Promteangtong; Anchisa Kunawudhi; Daris Theerakulpisut

Authors

Chanisa Chotipanich National Cyclotron and PET Centre, Chulabhorn Hospital
Chetsadaporn Promteangtong National Cyclotron and PET Centre, Chulabhorn Hospital
Anchisa Kunawudhi National Cyclotron and PET Centre, Chulabhorn Hospital
Daris Theerakulpisut Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University

Keywords:

PET/CT, cost, break-even point, feasibility

Abstract

At present, patients’ accessibility to positron emission tomography/computed tomography (PET/CT) service in Thailand is still not feasible due to high costs of diagnosis and limited disbursement of government health insurance schemes. The objective of this study was to study the costs and break-even point for the use of PET/CT devices in Thailand if additional indications were covered in health coverage schemes. Data collection of PET/CT service was performed at 2 government hospitals. Diagnosis costs, linear prediction, and budgetary impact were then analyzed.

The study showed that the unit cost of PET/CT would significantly decrease if the number of patients increased. The cost was approximately 367,045 baht per case if performed only 1 case a week and continuously decreased till 40 cases per week giving the unit cost only 22,725 baht. The disbursed rate of 40,000 baht per case would cause no loss to the hospital if performed 14 cases per week. The budgetary impact assessment expected an annual increase of 4.65% PET/CT uses with the disbursement of 40,000 baht per case. The annual conservative burden would amount to 24-26 million baht for new cases of patients with 9 types of cancer, excluding cases already underwent treatments, suspicious cases and recurrent cases that needed to be examined by PET/CT.

However, it is recommended that the disbursement for PET/CT service should be considered in Thai health service system due to low budgetary impact of 24-26 million baht per year. Moreover, the budgetary support for this disbursement should not be managed within the capitation payment.

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