Estimating uncompensated medical care cost as a result of adverse events in a university hospital in Thailand
, , and | Jan 31, 2017
About this article
Article Category: Brief communication (Original)
Published Online: Jan 31, 2017
Page range: 261 - 267
DOI: https://doi.org/10.5372/1905-7415.1003.489
Keywords
© 2016 Luleeya Ocharot, Jiruth Sriratanaban, Sureerat Ngamkiatphaisan, Narin Hiransuthikul
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Bivariate analyses of adjusted Thai- diagnosis-related groups (DRGs) case-mix index, length of stay, medical care costs per case, and standardized medical care costs per relative weight adjusted for a patient’s length of stay (adj. RW)
| Mean (standard error) | |||
|---|---|---|---|
| AE-positive group (n = 138) | AE-negative group (n = 436) | ||
| Adjusted Thai-DRGs case-mix index | 5.18 (0.62) | 1.94 (0.16) | <0.001* |
| Length of stay (days) | 17.40 (2.24) | 4.99 (0.38) | <0.001* |
| Medical care cost per case (US$) | 2,785.73 (417.46) | 861.41 (203.00) | 0.015* |
| Medical care costs per adj. RW (US$) | 525.11 (44.93) | 391.79 (27.10) | <0.001* |
Multiple linear regression analysis of the standardized medical care cost per relative weight adjusted for a patient’s length of stay (adj. RW) on the presence of adverse events (AE positive vs. AE negative) controlling for patient characteristics and clinical characteristics (n = 574)
| Outcome variable Medical care cost per adj. RW | Coefficient estimate | Standard error | 95% confidence interval |
|---|---|---|---|
| AE-negative group | ref | ||
| AE-positive group | 128.94* | 50.14 | 30.65,227.23 |
| Nonsurgical | ref | ||
| Surgical | −45.67 | 64.14 | -171.38,80.02 |
| Pediatrics | ref | ||
| Surgery | 194.10 | 165.16 | -129.60,517.81 |
| Obstetrics and gynecology | 168.76 | 130.22 | -86.47,423.98 |
| Internal medicine | 274.07 | 240.47 | -198.24,745.38 |
| Orthopedics | 98.86 | 137.60 | -170.82,368.56 |
| New born-1 year | ref | ||
| 1-25 years | 126.47 | 78.62 | -27.63,280.56 |
| 26-59 years | 15.29 | 159.44 | -297.21,327.80 |
| 60 years up | 125.34 | 184.39 | -236.07,486.74 |
| Male | ref | ||
| Female | −44.16 | 50.34 | -142.82,54.51 |
| Newborn | ref | ||
| Emergency | 57.96 | 79.39 | -97.63,213.56 |
| Outpatient department | -33.46 | 67.44 | -165.66,98.72 |
| Pay out of pocket | ref | ||
| Pay by insurance | 134.71 | 2380.86 | −4531.68,4801.10 |
Patient characteristics of the adverse event (AE)-positive and the AE-negative groups
| Patient characteristics | Number (percentage) of patients | Chi-square test | |
|---|---|---|---|
| AE-positive group (n = 138) | AE-negative group (n = 436) | ||
| 42.6 (24.5) | 33.2 (26.6) | <0.001 | |
| New born-1 year | 18 (13.0) | 90 (20.1) | 0.002* |
| 1-25 years | 14 (10.1) | 85 (19.5) | |
| 26-59 years | 62 (44.9) | 168 (38.5) | |
| 60 years up | 44 (31.9) | 93 (21.3) | |
| Male | 42 (30.4) | 180 (41.3) | 0.023* |
| Female | 96 (69.6) | 256 (58.8) | |
| Newborn | 32 (23.2) | 89 (20.4) | 0.045* |
| Emergency | 94 (68.1) | 271 (62.2) | |
| Outpatient department | 12 (8.7) | 76 (17.4) | |
| Pay out of pocket | 43 (31.2) | 208 (47.7) | 0.001* |
| Pay by insurance | 95 (68.8) | 228 (52.3) | |
| Surgical | 128 (92.8) | 327 (75.0) | <0.001* |
| Nonsurgical | 10 (7.3) | 109 (25.0) | |
| Surgery | 56 (40.6) | 98 (22.5) | <0.001* |
| Obstetric | 33 (23.9) | 105 (24.1) | |
| Pediatric | 22 (15.9) | 126 (28.9) | |
| Internal medicine | 18 (13.0) | 95 (22.0) | |
| Orthopedic | 9 (6.5) | 12 (2.8) | |