The cost of radiology procedures using Activity Based Costing (ABC) for development of cost weights in implementation of casemix system in Malaysia

Presently there is a gross lack of information on cost and cost weights in many developing countries that implement casemix system. Furthermore, studies that employed Activity Based Costing method (ABC) to estimate the costs of radiology procedures were rarely done in developing countries, including Malaysia. The main objective of this study is to determine the costs of radiology procedures for each group in casemix system, in order to develop cost weights to be used in the implementation of the casemix system. An economic evaluation study was conducted in all units in the Department of Radiology in the first teaching hospital using the casemix system in Malaysia. From the 25,754 cases, 16,173 (62.8%) of them were from medical discipline. Low One Third and High One Third (L3H3) method was employed to trim the outlier cases. Output from the trimming, 15,387 cases were included in the study. The results revealed that the total inpatients’ charges of all the radiology procedures was RM1,820,533.00 while the cost imputed using ABC method was RM2,970,505.54. The biggest cost component were human resources in Radiology Unit (Mobile) (57.5%), consumables (78.5%) of Endovascular Interventional Radiology (EIR) Unit, equipment (81.4%) of Magnetic Resonance Imaging (MRI) Unit, reagents (68.1%) of Medical Nuclear Unit. The one highest radiology cost weight, was for Malaysia Diagnosis Related Group (MY-DRG®) B-4-11-II (Hepatobiliary and Pancreas Neoplasms with severity level II, 2.8301). The method of calculation of the cost of procedures need to be revised by the hospital as findings from this study showed that the cost imposed to patient is lower than the actual cost

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

Impact of routine PCV7 (Prevenar) vaccination of infants on the clinical and economic burden of pneumococcal disease in Malaysia

<p>Abstract</p> <p>Background</p> <p>Pneumococcal disease is the leading cause of vaccine-preventable death in children younger than 5 years of age worldwide. The World Health Organization recommends pneumococcal conjugate vaccine as a priority for inclusion into national childhood immunization programmes. Pneumococcal vaccine has yet to be included as part of the national vaccination programme in Malaysia although it has been available in the country since 2005. This study sought to estimate the disease burden of pneumococcal disease in Malaysia and to assess the cost effectiveness of routine infant vaccination with PCV7.</p> <p>Methods</p> <p>A decision model was adapted taking into consideration prevalence, disease burden, treatment costs and outcomes for pneumococcal disease severe enough to result in a hospital admission. Disease burden were estimated from the medical records of 6 hospitals. Where local data was unavailable, model inputs were obtained from international and regional studies and from focus group discussions. The model incorporated the effects of herd protection on the unvaccinated adult population.</p> <p>Results</p> <p>At current vaccine prices, PCV7 vaccination of 90% of a hypothetical 550,000 birth cohort would incur costs of RM 439.6 million (US$128 million). Over a 10 year time horizon, vaccination would reduce episodes of pneumococcal hospitalisation by 9,585 cases to 73,845 hospitalisations with cost savings of RM 37.5 million (US$10.9 million) to the health system with 11,422.5 life years saved at a cost effectiveness ratio of RM 35,196 (US$10,261) per life year gained.</p> <p>Conclusions</p> <p>PCV7 vaccination of infants is expected to be cost-effective for Malaysia with an incremental cost per life year gained of RM 35,196 (US$10,261). This is well below the WHO's threshold for cost effectiveness of public health interventions in Malaysia of RM 71,761 (US$20,922).</p