ต้นทุนต่อวันนอนในการให้บริการการดูแลระยะกลางในผู้ป่วยโรคหลอดเลือดสมองในโรงพยาบาลตติยภูมิแห่งหนึ่ง

Orapan Sa-ringkan; Angsana Boonthum; Sukhontha Kongsin; Sukhum Jiamton; Phusit Prakongsai

Authors

Orapan Sa-ringkan M.Sc. Student in Master of Science (Public Health) Major in Community Health System Development, Faculty of Public Health, Mahidol University
Angsana Boonthum Faculty of Public Health, Mahidol University
Sukhontha Kongsin Faculty of Public Health, Mahidol University
Sukhum Jiamton Faculty of Medicine Siriraj Hospital, Mahidol University
Phusit Prakongsai Health Technical Office, Office of the Permanent Secretary for Public Health

Keywords:

cost, intermediate care, cerebrovascular diseases, tertiary hospital

Abstract

This research aimed at examining costs of intermediate care among patients with cerebrovascular diseases hospitalized in a tertiary hospital in fiscal year 2018. This study was a cross-sectional descriptive study collecting data from July to December 2019. Seventy patients with cerebrovascular diseases were recruited accruing 179 admissions and 1,417 admission days, average admission day per case equaled to 7.9 days. Research findings showed that 71.4% of participants were the universal coverage scheme (UCS) beneficiaries, 25.7% were beneficiaries of the civil servant medical benefit scheme (CSMBS) and 2.9% were members of the social security scheme (SSS). The full internal cost of intermediate care was approximately 2,293,622 baht. The highest cost was routine service cost (RSC) at 1,484,988 baht, followed by medical care cost (MCC) at 807,472 baht, while the capital cost (CC) was the lowest at 1,163 baht. Among different health insurance schemes, variation of full cost of each health scheme was marginal i.e. the UCS at 1,604, the CSMBS at 1,656, and the SSS at 1,716 baht per admission day. The full external cost of intermediate care among patients with cerebrovascular diseases was 4,722 baht per case consisting of 4,182 baht of direct non-medical cost per case, and 350–1,490 baht per case for opportunity cost.

Cost analysis using cost-bearer criterion into internal costs borne by providers and external costs borne by patients/families could guide health service planning integral to efficient financing at the heart of health system strengthening to improve health of the population, and achieve equitable access to essential health care service with efficient use of health resources.

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