Aljunid Syed Mohamed, Ali Jadoo Saad Ahmed
1 Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
2 Faculty of Public Health, Kuwait University, Kuwait.
Inquiry. 2018 Jan-Dec;55:46958018755483. doi: 10.1177/0046958018755483.
The steady growth of pharmaceutical expenditures is a major concern for health policy makers and health care managers in Malaysia. Our study examined the factors affecting the total inpatient pharmacy cost (TINPC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). In this retrospective study, we used 2011 administration electronic prescriptions records and casemix databases at UKMMC to examine the impact of sociodemographic, diagnostic, and drug variables on the TINPC. Bivariate and multivariate analyses of the factors associated with TINPC were conducted. The mean inpatient pharmacy cost per patient was USD 102.07 (SD = 24.76). In the multivariate analysis, length of stay (LOS; B = 0.349, P < .0005) and severity level III ( B = 0.253, P < .0005) were the primary factors affecting the TINPC. For each day increase in the LOS and each increase of a case of severity level III, there was an increase of approximately USD 11.97 and USD 171.53 in the TINPC per year, respectively. Moreover, the number of prescribed items of drugs and supplies was positively associated with the TINPC ( B = 0.081, P < .0005). Gender appears to have affected the TINPC; male patients seem to be associated with a higher TINPC than females (mean = 139.55, 95% confidence interval [CI]: 112.97-166.13, P < .001). Surgical procedures were associated with higher cost than medical cases (mean = 87.93, 95% CI: 61.00-114.85, P < .001). Malay (MYR 242.02, SD = 65.37) and Chinese (MYR 214.66, SD = 27.99) ethnicities contributed to a lower TINPC compared with Indian (MYR 613.93, SD = 98.41) and other ethnicities (MYR 578.47, SD = 144.51). A longer hospitalization period accompanied by major complications and comorbidities had the greatest influence on the TINPC.
药品支出的稳步增长是马来西亚卫生政策制定者和医疗保健管理者主要关注的问题。我们的研究调查了马来西亚国民大学医学中心（UKMMC）影响住院药房总费用（TINPC）的因素。在这项回顾性研究中，我们使用了UKMMC 2011年的行政电子处方记录和病例组合数据库，以研究社会人口统计学、诊断和药物变量对TINPC的影响。对与TINPC相关的因素进行了双变量和多变量分析。每位患者的平均住院药房费用为102.07美元（标准差=24.76）。在多变量分析中，住院时间（LOS；B=0.349，P<.0005）和III级严重程度（B=0.253，P<.0005）是影响TINPC的主要因素。住院时间每增加一天以及III级严重程度每增加一例，TINPC每年分别增加约11.97美元和171.53美元。此外，所开药物和用品的项目数量与TINPC呈正相关（B=0.081，P<.0005）。性别似乎对TINPC有影响；男性患者的TINPC似乎高于女性（平均值=139.55，95%置信区间[CI]：112.97-166.13，P<.001）。外科手术的费用高于内科病例（平均值=87.93，95%CI：61.00-114.85，P<.001）。与印度族（613.93马来西亚林吉特，标准差=98.41）和其他族裔（578.47马来西亚林吉特，标准差=144.51）相比，马来族（242.02马来西亚林吉特，标准差=65.37）和华裔（214.66马来西亚林吉特，标准差=27.99）的TINPC较低。较长的住院时间伴有严重并发症和合并症对TINPC的影响最大。
