Nor Azlin M N, Syed Aljunid S J, Noor Azahz A, Amrizal M N, Saperi S
Universiti Kebangsaan Malaysia, Faculty of Health Sciences, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
Med J Malaysia. 2012 Oct;67(5):473-7.
This study aimed to estimate cost of in-patient medical care due to stroke in a tertiary hospital in Malaysia. A retrospective analysis of stroke patients admitted to Universiti Kebangsaan Malaysia Medical Centre (UKMMC) between January 2005 and December 2008 were conducted. Cost evaluation was undertaken from the health provider's perspective using a top-down costing approach. Mean length of stay (LOS) was 6.4 ± 3.1 days and mean cost of care per patient per admission was MYR 3,696.40 ± 1,842.17 or 16% of per capita GDP of the country. Human resources made up the highest cost component (MYR 1,343.90, SD: 669.8 or 36% of the total cost), followed by medications (MYR 867.30, SD:432.40) and laboratory services (MYR 337.90, SD:168.40). LOS and cost of care varied across different stroke severity levels (p<0.01). A regression analysis shown significant influence of stroke severity on cost of care, with the most severe stroke consumed MYR 1,598.10 higher cost than the mild stroke (p<0.001). Cost of medical care during hospital admission due to stroke is substantial. Health promotion and primary prevention activities need to take priority to minimise stroke admission in future.
本研究旨在估算马来西亚一家三级医院中风住院医疗护理的费用。对2005年1月至2008年12月期间入住马来西亚国民大学医学中心(UKMMC)的中风患者进行了回顾性分析。从医疗服务提供者的角度,采用自上而下的成本核算方法进行成本评估。平均住院时间(LOS)为6.4±3.1天,每次入院每位患者的平均护理费用为3696.40马来西亚林吉特±1842.17,占该国人均国内生产总值的16%。人力资源构成了最高的成本组成部分(1343.90马来西亚林吉特,标准差:669.8,占总成本的36%),其次是药物(867.30马来西亚林吉特,标准差:432.40)和实验室服务(337.90马来西亚林吉特,标准差:168.40)。不同中风严重程度水平的住院时间和护理费用各不相同(p<0.01)。回归分析显示中风严重程度对护理费用有显著影响,最严重中风的费用比轻度中风高1598.10马来西亚林吉特(p<0.001)。中风导致的住院期间医疗护理费用相当可观。健康促进和一级预防活动需要优先开展,以尽量减少未来中风患者的入院人数。