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Volume 64, Number 5, September 2012

Estimating Patient-Level Costs for Acute and Sub-Acute Inpatient Services in Thailand
Orathai Khiaocharoen, B.N., Ph.D.,Supasit Pannarunothai, M.D., Ph.D,Arthorn Riewpaiboon, B.Pharm, M.Sc., Ph.D.,Chairoj Zungsontiporn, M.D.
Research Development Division, Phitsanulok Provincial Health Office, Centre for Health Equity Monitoring, Faculty of Medicine, Naresuan University, Faculty of Pharmacy, Mahidol University, Central Office for Healthcare Information, Thailand.


Objective: To determine patient-level cost of acute and sub-acute inpatient services and to examine factors predicting cost for patients requiring sub-acute care.
Methods: The study design was prevalence-based cost-of-illness approach. Subjects were 2,419 inpatients requiring sub-acute care in 2 regional hospitals. The costs of services were calculated employing standard costing methods. Inpatient costs were prospectively recorded from July 2008 to February 2009. Micro-costing approach was employed under a provider perspective. Paired-t test was used to evaluate the significant difference.
Results: The average cost during the sub-acute phase was much lower than that in the acute phase (14,877 vs. 23,089 Baht). Nursing service constituted the highest cost (42.6%) in sub-acute phase, whereas direct rehabilitation costs was only 2%. Burn with low physical function had the highest average costs (67,243 Baht). The average cost was significantly higher than the average charge (p<0.001). The physical function at admission, Rehabilitation Impairment Category (RIC) and length of stay (LOS) were the key determinants of sub-acute service costs (adjusted R2=0.688; p<0.001).
Conclusion: The cost in sub-acute phase was lower than the cost in acute phase. Physical function, RIC and LOS could be used to predict cost of sub-acute inpatient services.

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