Estimating uncompensated medical care cost as a result of adverse events in a university hospital in Thailand
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.
Background
The impact of adverse events on costs of medical care in developing countries is more limited than in developed countries.
Objective
To estimate uncompensated medical care costs as a result of adverse events in hospitalized patients.
Method
Retrospective study based on a panel reviews of the medical records and hospital charges relating to 574 inpatients in the electronic database of a tertiary-care university hospital in Bangkok, Thailand, of which 138 were identified to have adverse events in 2009. The main outcome measure was hospital charges for medical care standardized by Thai diagnosis-related groups (Thai-DRGs).
Result
After controlling for personal and clinical factors, the average medical cost of an adverse event was estimated at US $128.98 per adjusted relative weight of Thai-DRGs, equivalent to 52% of the standard payment rate paid to the hospital set by a Universal Coverage Scheme.
Conclusion
Adverse events in the hospital increased the cost of medical care despite adjustment for the case-mix based on DRG. Under the close-ended DRG-based payments for hospitals in Thailand, this meant that adverse events resulted in significant amounts of uncompensated care.