Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study

Objective: Facial injury (FI) may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]). The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. Materials and methods: A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment. Direct cost analysis, comparison of cost and length of hospital stay, and Injury Severity Score (ISS) were performed. Results: A total of 190 patients were enrolled in the study, of whom 83 (43.7%) had FI only, and 107 (56.3%) had FOI. The mean ISS was 5.4. The mean length of stay and costs for patients with FI only were 5.8 days with a total cost of US$1,261.96, whereas patients with FOI were admitted for 7.8 days with a total cost of US$1,716.47. Costs doubled if the treatment was performed under general anesthesia compared to local anesthesia. Conclusion: Treatment of FI and FOI imposes a financial burden on the health care system in Malaysia

An implementation of activity-based costing (ABC) approach for analysing cost of community-based rehabilitation (CBR) activities for disabled children

Introduction Activity-based costing (ABC) is a method to estimate costs by time motion activity. All activities run in the program were evaluated. Objective The objective of this study is to estimate costs of all activities in Community-based rehabilitation (CBR) program for disabled children. Methodology Time motion study was conducted from March 2015 to April 2016 to determine time taken for each activity run by the assigned staff. A costing form was used to impute cost of CBR activities. The total annual gross income of assigned staff was divided by 22days/month, then 6 hours or 8 hours to calculate cost per minute for each activity. Results The results showed that, total cost for CBR activities in 12 months program was RM 39,408,009 with mean RM 218,933 (range: RM 0 – RM 977,675). The highest cost of routine CBR activity is fardhu ain with mean of RM 72,036 (range: RM 0 – RM62,836) and the lowest mean cost of CBR routine activity is RM 491 (range: RM 0 – RM 1,745). The highest mean cost for support team activities is for medical team with mean of RM 1,336 (range: RM 0 – RM 3,225) and the lowest mean cost is an assessor panel from Department of Education RM 3 (range: RM 0 – RM 280). Conclusion Cost of CBR activities can feasibly be determined using ABC approach. All data obtained can be evaluated for future financial planning by the policy maker to enhance CBR program in future

Implementation of an Activity-Based Costing (ABC) approach for analyzing the cost of community-based rehabilitation activities for disabled children

INTRODUCTION: Activity-based costing (ABC) is a method to estimate costs by time motion activity. All activities run in the program were evaluated. OBJECTIVE: The objective of this study is to estimate costs of all activities in Community-based rehabilitation (CBR) program for disabled children. METHODOLOGY: Time motion study was conducted from March 2015 to April 2016 to determine time taken for each activity run by the assigned staff. A costing form was used to impute cost of CBR activities. The total annual gross income of assigned staff was divided by 22days/month, then 6 hours or 8 hours to calculate cost per minute for each activity. RESULTS: The results showed that, total cost for CBR activities in 12 months program was RM 39,408,009 with mean RM 218,933 (range: RM 0 – RM 977,675). The highest cost of routine CBR activity is fardhu ain with mean of RM 72,036 (range: RM 0 – RM62, 8363) and the lowest mean cost of CBR routine activity is RM 491 (range: RM 0 – RM 1,745). The highest mean cost for support team activities is medical team with mean of RM 1,336 (range: RM 0 – RM 3,225) and the lowest mean cost is an assessor panel from department of education RM 3 (range: RM 0 – RM 280). CONCLUSION: Ample cost of CBR activities can be determined using ABC approach. All data obtained can be evaluated for future financial planning by the policy maker to enhance CBR program in futur

Parents’ and caregivers’ costs of community-based rehabilitation (CBR) programme for disabled children in east coast region of Peninsular Malaysia

Rehabilitation for disabled children requires long-term programmes which are expensive to the family. This study aimed to estimate the cost incurred by parents and caretakers of disabled children participating in the Centre-Based and Home Based Community-Based Rehabilitation (CBR) and cost of seeking alternative care. Activity-Based Costing (ABC) method was the cost analysis approach used to estimate twelve-months expenditure by 297 (160 in Centre-based and 137 in Home-based) parents and caretakers of disabled children aged 2 to 18 who attended CBR and seek alternative care. Costing was undertaken from societal perspective. Data were collected using a self-administered costing questionnaire and were presented in median (IQR) cost calculated for the 2014 institutional financial year. Results showed that the median total cost for CBR programme, including alternative care were significantly higher in Centre-Based compared to Home-Based group (RM 7,392 (6,849) vs. (RM 8,066 (36,939) (p value <0.001). The median direct and indirect costs, excluding medications and alternative care were nearly four times as high in Home-Based compared to Centre-Based (RM 2, 376 (11,228) vs. RM 608 (739) (p = <0.001). Parents and carers in Centre-Based spent RM 1,320 (1,978) on medication and supplements compared to only RM 450 (877) for those in Home-Based group. Both groups of parents and carers spent significant amount of resources on alternative care. Although, the cost of alternative care is 90.9% of the total cost for Centre-Based group compared to 55.8% in the HomeBased group, difference is not significant (p-value = 0.543). The high costs incurred for alternative care is a major economic burden to the family. Thus, further studies evaluating the cost effectiveness of alternative care for rehabilitation of disabled children are warranted