Cost of hospitalizing asthma patients in a regional hospital in Thailand

Abstract

Cost of hospitalizing asthma patients in a regional hospital in Thailand CHUESAKOOLVANICH K. Respirology 2007; 12: [433][434][435][436][437][438] Background and objective: The hospitalization of asthma patients accounts for substantial costs in any health-care system. However, the utilization of medical resources and the cost of hospitalizing asthma patients in Thailand have never been evaluated. This study aimed to evaluate the utilization of health-care resources and itemize the cost of hospitalizing asthma patients in a regional hospital in north-east Thailand. Methods: A cross-sectional, retrospective study was conducted at Surin Hospital, a 697-bed, regional hospital in north-east Thailand. The study included 183 adults (≥15 years of age) who were admitted with acute asthma. Demographic data, resource-utilization parameters and itemized costs were recorded. Results: The average hospital cost was TH 5809.3 ± 6587.4 (US$134.5 ± 152.5) per patient (range, TH 740-57 980 or US$17.1-1342.1). Medications were the primary hospital expense (47.2%), followed by hospital charges (13.5%), nursing care (13.0%) and respiratory therapy (12.2%). Fifteen per cent of patients accounted for 45% of total hospital costs. Significant predictors of increased total hospital cost were: (i) age ≥60 years; (ii) presence of comorbid conditions; (iii) admission to the intensive care unit; and/or (iv) prolonged hospital stay. Conclusion: Despite the low unit costs for inpatient care in Thailand, the cost of hospitalizing asthma patients (especially the elderly) constitutes a substantial burden to the health-care system.

Out-of-Pocket Costs of Asthma Follow-Up Care in Adults in a Sub-Saharan African Country

“…This figure is similar to the 81%, 84%, and 89% found in Turkey, Germany, and Australia, respectively [10,16,22], but higher than other studies which reported that medication costs corresponded to a range between 30 and 47% direct costs of asthma care [12][13][14]. The differences in prescription costs noted may be due to differences in the types of medication given to the patients, doses of medication required by each patient, and the severity of their asthma.…”

“…The differences in prescription costs noted may be due to differences in the types of medication given to the patients, doses of medication required by each patient, and the severity of their asthma. Furthermore, lower cost of laboratory tests and consultations in developing countries compared with developed countries might have accounted for the lower treatment costs observed in our setting [8][9][10][11][12][13][14]. Also, we have shown that costs of follow-up care for asthma patients did not differ significantly across age, education, marital status, residence, or gender categories.…”

“…The average asthma-related direct costs of care in developed countries ranged between $273 in Australia, $1779 in Switzerland, and up to $4101 in the United States of America per patient annually [5,17,18]. In developing countries, average direct costs of asthma care per patient annually ranged between US$135 in Thailand, US$276 in Malaysia, and US$1,466 in Turkey [10,12,19]. In the USA and Turkey, the total cost of asthma was estimated as US$12.7 billion and US$1.9 billion, in 1998 and 2004, respectively [10,14].…”

“…For example, Nigeria has a gross national income of US$1, 200 per capita compared with the United States where it is US$41, 400 per capita [21]. Additional reasons may be due to differences in healthcare delivery system; for example, patients in Malaysia and Thailand [12,19] receive financial protection through government health insurance schemes which are currently at an early stage in Nigeria.…”

“…This results in a considerable high proportion of uncontrolled asthma, which is associated with greater economic burden to families and the health system and deterioration in quality of life [7][8][9]. In high-/middle-income countries, costs of asthma inpatient care [10], hospitalization [10][11][12], and exacerbations [13] have been previously documented. However, reports on cost of asthma followup among individuals with poorly controlled asthma are lacking worldwide.…”