Economic burden of diabetic care in government health facilities in Selangor

Background : The worldwide prevalence of diabetes is increasing, as is the demand for and cost of medical care. Diabetic Mellitus (DM) prevalence in Malaysia rose from 6.3% of the population in 1986 to 8.3% in 1996 and costs need to be managed more effectively. Objective : To estimate the financial burden of diabetic care, including providers’ and patients’ costs in government facilities in Selangor and to determine factors influencing cost of diabetic care. Methodology : A cross-sectional study was conducted from September to November 2005 among Hospitals with and without Specialist and Health Clinics. Total sample of 361 subjects with type 2 diabetes representing both inpatient and outpatient were chosen randomly. Results were analyzed using SPSS version 13.0. Results : The average cost for a diabetic patients’ admission in a Hospital with Specialist was RM1951 and RM1974 for patient admitted in a Hospital without Specialist and these cost difference was not statistically significant (p>0.05). Providers’ mean cost for outpatient care was RM772.69 and RM761.07 respectively for Hospital with Specialist and Hospital without Specialist per year. As for the health clinics the average providers’ cost for a patient was RM385.92 per year. The cost difference was statistically significant (p0.05). The mean total costs of outpatient care were RM841.46, RM832.80 and RM458.01 per year for Hospital with Specialist, Hospital without Specialist and Health Clinics respectively. Level of care and length of stay were the influencing factors for inpatient provider’s cost. The overall provider’s cost for outpatient diabetic care was influenced by level of care, number of visits and complications. Cost of treating diabetes mellitus year 2004, was estimated at RM18,956,021.51 which was equivalent to 3.3% of total state health expenditure. Conclusion : As much as 60.2 % was spent on management of outpatient diabetic care and 39.8% for management of inpatient diabetic care. Financial burden of diabetic care is predominantly for outpatient care. Therefore, effective and efficient management of outpatient care is needed to improve allocate efficiency, equity, accessibility and appropriateness of the health care system so that the health care services delivered to the nation are of good quality

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

Bin Sulong Saperi,1 Roszalina Ramli,2 Zafar Ahmed,1 Amrizal Muhd Nur,1 Mohd Ismail Ibrahim,3 Muhd Fazlynizam Rashdi,2 Rifqah Nordin,2 Normastura Abd Rahman,4 Azizah Yusoff,4 Abd Jabar Nazimi,2 Roselinda Abdul Rahman,4 Noorhayati Abdul Razak,4 Norlen Mohamed 5 1International Centre for Casemix and Clinical Coding, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, 2Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, 3Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 4School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, 5Malaysian Institute of Road Safety Research, Kuala Lumpur, Malaysia 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. Keywords: facial injury, road traffic crashes, cost analysis, university hospitals, Malaysi