/pidsdps9512

Page 1

Philippine Institute for Development Studies

Costs of In-patient Hospital Care for Bronchopneumonia and Acute Myocardial Infarction in Manila Tessa L. Tan-Torres DISCUSSION PAPER SERIES NO. 95-12

The PIDS Discussion Paper Series constitutes studies that are preliminary and subject to further revisions. They are being circulated in a limited number of copies only for purposes of soliciting comments and suggestions for further refinements. The studies under the Series are unedited and unreviewed. The views and opinions expressed are those of the author(s) and do not necessarily reflect those of the Institute. Not for quotation without permission from the author(s) and the Institute.

June 1995 For comments, suggestions or further inquiries please contact: The Research Information Staff, Philippine Institute for Development Studies 3rd Floor, NEDA sa Makati Building, 106 Amorsolo Street, Legaspi Village, Makati City, Philippines Tel Nos: 8924059 and 8935705; Fax No: 8939589; E-mail: publications@pidsnet.pids.gov.ph Or visit our website at http://www.pids.gov.ph


1

Costs of In-patient Hospital Care for Bronchopneumonia and Acute Myocardial infarction in Manila

Tessa L. Tan-Torres, M.D., M.Sc. December, 1994


2

ABSTRACT COSTS OF IN-PATIENT HOSPITAL ACUTE MYOCARDIAL INFARCTION Clinical Epidemiology Unit, College of Medicine.

CARE

FgR BRONCHOPNEUMONIA AND IN MANILA. T Tan-Torres. University of the Philippines

OBJECTIVES: i. to describe the mean age of patients, hospital outcomes, frequency of utilization of tests, cost of medications and length of stay for pneumonia

their median (acute

myocardial infarction) in selected hospitals in Metro Manila; 2. using a standard set of prices, compare the median costs of hospitalization for pneumonia (and AMI) in the different hospitals; 3. if there is a difference, to estimate the contribution of three hospital descriptors: level of care (1,2,3), ownership (private and government) and teaching status (teaching and non-teaching) 4. if the descriptor contributed an increase, to determine the extent of increase in the cost categories of '_diagnosis, treatment and hospital stay. SAMPLE: First Stage: Hospitals who had participated in a previous survey constituted the sampling frame. A hospital was selected if it represented different descriptors (e.g. primary, government, non-teaching) and the administrator agreed to allow access to patient records. Second Stage: 200 consecutive patients who were admitted to the hospital with the diagnosis of pneumonia or AMI were included. METHODS: Charts were reviewed to get utilization data on diagnostic tests, medications, procedures and length of stay. Standardized costs were obtained from a previous study which derived costs by estimatiDg actual resource use. The data were analyzed using descriptive statistics of medians and ranges. Comparison between groups was performed with Kruskalwallis test. RESULTS: For Pneumonia: • There were 6 hospitals in the pneumonia first and

data set which could second level of care

demonstrate contrasts for government-owned,

between private

and government-owned in secondary and tertiary care levels. Mean age ranged from l.lz:to 1.9 years. Death rates ranged from 0-7.9%. Length of stay varied from 2.5 to 6 days, number of diagnostic tests performed ranged from 2.4 to 12 and costs of treatment ranged from P929 to P2959. For the same level of


3 care, government hospitals had higher total costs of hospitalization (P<0.05) and for private hospitals, a higher level of care was associated with a higher cost of { hospitalization (P<0.05). For Acute Myocardial Infarction: Fouri tertiary care, teaching hospitals entered the study. The only contrast possiblewas private versus government. Mean age ranged from 49 to 53 years and death rates varied from 2.6 to 10.3%. Length of stay ranged from 8.3 to 12.3 days, diagnostic tests from 20 to 33 tests and treatment costs from P522 to P729. The private hospital had lower hospitalization costs compared to the government hospitals. CONCLUSIONS: Data collected in the pneumonia data set are consistent with current literature of obtaining higher costs in government-owned and higher level facilities. Most of the additional costs occurred in length of stay and diagnostic tests. For AMI, there were higher costs and higher mortality rates seen in the government hospital. No information could be obtained on the role of teaching versus hospitals as no contrasts were obtained ineither RECOMMENDATIONS: i. recommend the use algorithms to standardize care efficiency; 2. enrol more patients in a prospective study tq allow including standardizing for severity

non-teaching data set. of validated

and possibly, and additional better data of illness

increase hospitals collection


4

INTRODUCTION: Hospital care, by the nature of its _ technology, is very resource-intensive. Over the past ten years, it has accounted for not less than 60% of. the budgetary outlay of the Department of Health (i). In 1990, approximately P5 million was allocated for hospitals. Compared to expenditures for primary care interventions .like i_nunization, this amount benefits fewer individuals. Considering the disproportionately large sums of money spe_t on the hospitals, it is imperative that the practices in the hospital are constantly _ examined and reviewed for effectiveness and efficiency. As a first step, the costs of hospitalizing ill individuals, can be determined and the impact of hospitalization on the patients' health status documented. Data can subsequently be aggregated for analysis to answer questions on resource utilization, practice patterns and patient outcomes. What is the cost of treating a patient with pneumonia in a tertiary care. setting? What if the care was provided in a lower level facility? Is it less costly? Is it, at least, equally effective? Would a teaching hospital produce better patient outcomes compared to a non-teaching hospital? Would they carry out more tests? Are there differences in the cost and quality of care being provided in a private versus a government hospital? What would account for these differences, if any? The information obtained can provide policymakers with a basis for planning and financing services within the hospital sector. It can suggest areas where policy action is needed, define which policies will have better chances of successful implementation and indicate where more studies have to be u_dertaken. Conceptual

Framework:

To systematically framework in fig.

explore the issues 1 will be used.

raised,

the

conceptual


5

PHYSICIAN Hospital: ownership level of

__PATIENT ISeverity

---

status

TOTAL

COST

Number

x

(Diagnosis,

cost

of

summing

hospitalization

the

products

therapeutic cost

of

TC=NdxCdx where: = coCal

N=

number

C=

cos t diagnostic

tx

=

therapeutic

ho

= hotel

rate

is

the

tests

will

decisions

illness

of

can

units

including

Algebraically,

be

(of

"hotel" this

Hotel)

can

obtained

diagnostic sEay)

be

interventions, or

room

and

utilization

N

who

be are

or

and

the

represented

by

done

and

procedures

board.

depends

on

the

's condition. to the use of

actually

writes

what

primarily

including

down

The resources

the

medications

influenced

physician

orders

will

by

the

be

and

of

th_

his

physician (2). He for

which

given.

existing

His

standards

in. his area (3), adjusted for the level of severity of the patient. In general, the more severe the more intensive the use of resources in

management

by

+ NhoCho

of the patient as the gatekeeper

person

of care illness illness,

number

Treatment,

interventions

stay

of

assessment functions

an

Cost

cost

dx _

The

of

unit.

+ NtxCtx

TC

for

interventions,

each

illness

care

teaching

The

of

of the the

patient. l

The

standards

defining environment

the

of type can

care of be

in

a

given

hospital described

area

the in

can

physician terms

be

approximated

practises of

in.

availability

by The of


6 technology, efficiency

presence of external (dis)incentives and teaching/training star.us.

to

improve

The availability of technology simply_ means that if it _S there, it can be used. For example_ a device called a pulse oximeter monitors the amount of oxygen in the blood and can be used to assist anesthesiologists providing general anesthesia to a patient. The device can d%termine the adequacy of respiration in a patient more precisely than clinical observation. This increase in precision theoretically should lead to better patient outcomes. A randomized trial has not demonstrated any difference in patient outcomes in terms of perioperative complications and deaths but 80% of anesthesiologists felt more secure with the device and 18% of them could recall an episode where the use of the oximeter had helped to avoid a serious incident. Despite the absence of impact on the patients, in North America (4). The

availability

of

convincing the pulse

technology

information oximeter is

defines

the

with regard to now widely used

level

of

care

which

can be provided to patients: Higher level hospitals have high import intensities (ratio of total imports generated to gross output) and cost more to maintain. In Malawi, average costs per inpatient in a general hospital is at least twice the cost in a district hospital (5). The ownership of the use. Supplier-induced documented r_diation

technology demand

is

available also a phenomenon

empirically. Physicians who therapy machines, may practise

increase utilization rates beyond of patients being seen (6).

those

influences which has

own equipment, "self-referral', expected

for

the

its been e.g. and type

Viewed in a different light, privately-owned hospitals may be managed more efficiently than those owned by the government. Theoretically, administrators or physicians will have an incentive to provide services of a given quality at a minimum cOSt if they have "rights to the future profits resulting from _he operation of the hospital". Among future

governm_ profits

hospitals, the and performance

connection between is n_bulous and in

rights fact,

to the


7 government hospital has a stated mission of providing medical care to all (as a last resort) which might conflict with the aim of maximizing the value of their future income (7). :

?

In Lesotho, average cost per inpatient in a public hospital was three times higher than that in a private hospital (5). However, case studies of transfer of public hospitals from local governments to more autonomou_ agencies in the US were not able to show any clear gains iniop_rating efficiency (7). In Malawi, there was also no difference demonstrated (5). Finally, standards of practice associated with academic settings usually imply higher rates of utilization. Teaching physicians may order a test because of the need to document a phenomenon, whether or not documentation of such phenomenon can influence the patient's outcome. Residents and training fellows, due to inexperience and inadequate supervision, may order more tests unnecessarily (7,8). There is some evidence to show that costs increase proportionately with expansion of a teaching program (7). To test the soundness of the model, two illnesses were selected for study, acute myocardial infarction (AMI) and bronchopneumonia (BPN). The two were selected to represent the opposite poles of an epidemiologic transition, infectious and degenerative. In addition, pneumonia is primarily a disease of children and myocardial infarction, a disease of adults. Finally, both diseases have widely accepted clinical grading systems which can be applied to assess severity of illness for purposes of controlling this variable. Acute

Myocardial

Infarction:

Acute myocardial infarction or 'heart attack' as it is more commonly known, is the medical term used when a portion of the muscles of the heart dies because of lack of oxygen. This is usually due to blockage, by deposits or inflammation, of the blood vessels supplying the area effectively preventing the continuous flow of blood bringing the oxygen. Mortality total of diseases

rate due to 9006 deaths of the heart

AMI is 22.6/100,000 population with a reported. It is classified under which is the leading cause of death in


8 the country in 1993. The five year second leading cause of death (9).

average

puts

it

as

the

There are no national figures for morbidity due to AMI. An ongoing cohort study on AMI started in 1992 by the Philippine Heart Association and the Philippine College of Physicians reveals a case fatality rate of 12% with a range of 6-24%. This is based on the data from 600iAMI patients admitted to various hospitals, mainly in Metro Manila (personal communication, Dr. A. Dans). Applying this case fatality rate on the 9006 deaths, there would have been at least 75,050 individuals who suffered an AMI in 1990. Admittedly, this is a very crude approximation of the burden of illness due to AMI. However, it clearly constitutes a major burden, particularly on the males during their productive years (see figure 2). Acute myocardial infarction strikes suddenly and the individuals are usually unprepared for the financial burden that it imposes. Individuals who suffer an AMI and reach a hospital alive (10% don't) are hospitalized, usually in an intensive care or coronary care unit. In the United States, 1988 figures suggest that approximately one million individuals suffer an AMI with Medicare charges reaching an average of $7,200 per initial hospitalization using conventional treatment (I0). The advent of invasive diagnostic and therapeutic procedures like angioplasty or coronary artery bypass surgery (operative repair or replacement of blocked blood vessels) and the introduction of thrombolytic therapy ("clot-busters" for the blocked blood vessel) have made available a new array of effective and expensive choices for the m@nagement of these patients (ii). Given patients standardized for age and other demographic characteristics, variation in use of procedures, e.g. coronary arterybypass grafting (12), has been demonstrated in North America. Availability of on-site facilities to perform these procedures increases the odds of the procedure being performed by seven times for angioplasty, five times for cardiac catheterization and two times for bypass surgery (13).


9 The teaching status of a hospital may also influence resource utilization. However, a recent study on the influence of teaching status on costs of care speciffc to the diagnosis of acute myocardial infarction showed that patients in a teaching service had a median length of stay shorter by 0.5 days (p=0.009) and hospital charges lesser by $1,653 (p=0.07) compared to patients on a non-teaching service in the same hospital. Patients on the teaching service also had 15% fewer cardiac catheterizations and 9% fewer revascularization procedures. Results were obtained after adjusting for demographic characteristics and severity of illness based on clinical parameters. This surprising finding was hypothesized to be due to the increasing awareness of clinicians about costs starting in the early 80's and the rigorous assessment of severity of illness based on clinical parameters specific to AMI. Previous studies illustrating increased costs associated with teaching hospitals were carried out mostly prior to the 80's. Also, among the more recent studies, severity of illness was controlled using DRG (diagnosis-related groups) case mix adjustment. This might not have been sensitive enough to truly adjust for severity o_ illness. Extraneous sources of variation were also minimized by the use of one hospital with teaching and non-teaching services (14). Bronchopneumonia: Bronchopneumonia in childre_ under the age of five years is a leading cause of death among children in developing countries (15). In the Philippines, a cohort of children in this age group in 709 households was followed up from 1985 to 1987 to determine the incidence of pneumonia. The incidence of pneumonia, both moderate and. severe cases was 0.5childyear (16). Of this, 4-13% would require hospitalization (17). If the population at risk in 1990 was 8,505,079 (9), a minimum of 170,101 children needed to be hospitalized for severe pneumonia. There are very few studies on costs of treatment of pneumonia in children (18). The large economic burden of illness due to pneumonia is due more to the frequency with which the


i0 condition

occurs

rather

than

to

use

of

expensive

technology,

e.g. a small ticket item which adds up to a large amount. A local study on hospital costs in a rural area in 1989, estimated the cost of hospitalization to be P2,144 for five days (17). The care of children with acute respiratory infections is included in the care of the sick child, a cost-effective package recommended in'the World Development Report 1993 (19_). ,i OBJECTIVES: This project I. describe

was carried out to: the mean age of patients,

their

hospital

outcomes,

frequency of utilization of tests, mean costs of medications and length of stay for pneumonia (and acute myocardial infarction) in different hospitals in Metro Manila; 2. using a standard (and hospital specific) set of prices, compare the mean costs of hospitalization for pneumonia (and acute myocardial infarction) between the different hospitals; 3. if there is a difference between the mean costs of hospitalization of pneumonia (and acute myocardial infarction), estimate the contribution of each descriptor (level of care, government ownership and teaching status) to the base cost of hospitalization in a private, primary, non-teaching hospital; 4. if the descriptor contributed an increase in the base cost, determine the extent of increase in each of the different cost categories hotel). METHODOLOGY Sampling Hospital

(diagnostic,

therapeutic,

and

length

of

to

time

available,

stay

or

: : Selection:

Due

the

short

selection

of hospitals was limited to those in Metro Manila which already had participated in the hospital survey of the Philippine Institute of Development Studies baseline projects for health financing (annex I) . One hospital representing each of the different combinations of hospital descriptors (e.g. primary, private, non-teaching enroled into the study provide access to data

or tertiary, government, teaching) was after the hospital administrator agreed to from hospital charts and their charges.

Level of care was based on th_ classification Bureau of Licensing and Regulation. Teaching

provided by hospitals

the are


ii those

with

medicine

residency

training

accredited

Specifically,

by

one

descriptions

programs

their

hospital

in

respective each

was

pediatrics

specialty

seiected

care

level,

private

primary

care

i evel,

government

secondary

care

secondary

level,

care

level,

private,

teaching

tertiary

care

level,

private,

non-teaching

tertiary

care

level,

government,

teaching

tertiary

care

lev_l,

government,

non-teaching.

SamDlinq of

age

2.

presence

3.

x-ray

4.

admission

200

less

patients

than of

hours

admission

were

inclusion

2.

electrocardiogram

3.

no

onset

of

in

date

The

inclusion

and

of

were

to

per

hospital

was

the

following:

set.

The

years;

on

admission;

I,

1989.

respirators

excluded for

(<24

from

acute

with

cut-off

(not

that temporal standards of

hours) reading on

or

the

who

died

within

48

study.

myocardial

of

infarction

April

were

the

respect to

exceed

were

trained

pre-tested

.=. senior

mm

Hg).or

tales

examination;

were of ago) of

new

medical

to guidelines

designed

comparable

severity 5. years

changes due to entry care were minimized.

and

infarction;

<90

1989.

hospital to

myocardial

physical

i,

pain

pressure

criteria

each

chest

acute

blood

exclusion in

severe

admitting

after

Chart Abstractinq; •Two teams of doctors using

of

(systolic

patients

particularly

exposure)

were five

April

attached

the "lungs)

admission

charts,

to

pneumonia

after

hypocension

4.

date

disease

pneumonia

equal

criteria

recent

sample

per

:

I.

(fluid

for or

date

who

following

•

cough;

reading

Patients

The

following

:

criteria

I_

of

the

government

level,

inclusion

fit

private

care

target

boards.

to

tertiary

A

internal

:

primary

Patient

and

abstract and

illness. was

to

with

assemble each

The

instituted

technology

students data forms

admission to

and

(with

ensure

changing

clinical

from (annex

a

other,

the 2).

One


12 supervisor

per

research

team

of

stay,

medications

length

and

!dentifÂĽinq, of and

the

room, served

outcome

stay date

General

data

use

and

Valuing

of

of

diagnostic

tests,

Inputs: generated, This was

days

in

based on the date of checked by comparing

admitting

and ward and The cost of

(PGH)

from

The

characteristics,

the the

section total length

derived using the costs of a day in care unit and ward as determined

came

abstraction.

patient

discharge,

was computer of discharge.

number

Hospital

prices

of

on

procedures.

intensive care (diet orders).

cost) was intensive

accuracy data

on

special

total

the

recorded

Measurinq

The length admission with

checked

assistants

study

the

of

resource

different

or

number of of stay

th@ in

use.

meals (hotel

emergency room, a Philippine

A

hospitals'

emergency

second

set

charges

for

of

ward

patients. The frequency of use of diagnostic tests results attached in the chart and from the Recording

was

through PGH

the

study

second

The

done

computer,

which

set

using

and

management

(e.g.

Cardiovascular

purchase

price hospitals

of

the

respective

generate

any

of

The the

the

list two were

reviewing

the

using

sets

two

hospital's

one

of of when

generated

set

resource

from

the

and

the

use

used

to

determine

Medications

set

of

prices

General

set).

then

A

set

the

different

costs.

The

and

recorded

used,

the

pharmacy

of

was

applied

prices,

charges

hospitals,•was Philippines

quarter,

grouped

etc) Hospital,

second

a price

were

1994) was

the

not

used

Index

provided available

of the

through

sources. obtained doctor's of

charges. the

on

anti-infectives,

(first price

prices:

were

patient.

pharmacies set

were

actual sheet.

hospital.

pages

Philippines

(standard

of based

each

first

Specialties

Procedures

summing

the

Costs

sets cost

of

drugs,

another

manufacturer's

two

fluids

of

of

all

Medical

the

test.

the

charges

Costs.

to to

per

using

the

medical

as

use

determined

medication

directly

as

was based from doctor's orders

prices, The

diagnostic,

from orders the total

the

first

pages.

Costs

standard costs

therapeutlc

page PGH

per and

of were

set

patient hotel

the

chart

again

and

the

were costs.

and

by

obtained respective

obtained

by


13 Inconsistencies and determining fidelity data entry.

outliers of chart

were checked as to abstraction, recording

accuracy by and computer

ANALYSIS: Descriptive deviations,

statistics (means, medians, percentiles, skewness, kurtosis and distributions) were

standard generated.

Analysis of variance with Pairwise comparison was done to determine the comparability Of sroups of patients in the different hospitals with respect to age. Proportions of patients With other co-existing disease were also documented. Patient outcomes were reported in terms of proportions of dead, alive, with complications or discharged against medical advice. Kruskal-Wallis determine if

test with pairwise comparison there are differences in

hospitalization

among

Revision

of

Protocol:

was also done median costs

to of

the hospitals. '

After a survey of the hospitals concerned and an interview of the hospital administrators, it was evident that in Metro Manila, all tertiary care hospitals have accredited residency training programs in internal medicine and pediatrics. There are no tertiary care hospitals which are non-teaching in the metropolis. Also, _overnment, primary care level hospitals are merely lyingin hospitals which do not admit patients for illnesses like pneumonia. Thus, for pneumonia, there were only 6 hospitals studied with the secondary care, private hospital category represented by two hospitals. Patients with myocardial infarctions seen at lower level facilities are immediately referred to tertiary care level facilÂŁ_les. Thus, three hospitals were studied with one hospital contributing patients to both government and private categories or a total of two hospitals per category and two categories, private and government tertiary _are, teaching hospitals.


14

RESULTS: Pneumonia: The hospitals included were:

(descriptions

i. Primary Care, Bagbaguin Family hospital

with

Pediatrics 2.

and

Secondary

Pasay

City

100%

3.

Care,

392

4.

Care,

Secondary

Clinica

for

Tertiary

University (no report

ten

Tertiary

The

Philippine

City

of

for

reports)

is

these

an

beds

pediatrics

a

100-bed

beds

are

pediatrics

8-bed

are in

for

1991.

in

hospital for

with

pediatrics

a and

1991.

I in

beds

for

in

Novaliches,

Quezon

pediatrics.

City

There

is

a 50-

were

1839

1991. II

Hospital 12

pediatrics

Care,

is

these

(CGH)

Private

beds in

(CAGH) for

in

Sta.

Crux,

pediatrics.

Manila

There

is

were

256

1991.

Private

of Santo submitted

6.

of

Private

with

Care,

q_o

admissions

for

General

hospital

admissions 5.

Care,

hospital

_ Caloocan

in

(PCGH)

Twenty

pediatrics

Arellano

50-bed

230

BLR

Government

Hospital

for

1991

rate.

Hospital

with

admissions

were

admissions

General

hospital

(BFH)

occupancy

rate.

Secondary

bed

70%

General

were

Casaul

Private Hospital

there

occupancy

there

a

a

from

Tomas (UST) to BRL).

is

a

502-bed

(private)

hospital

Government

General

Hospital

a 93% occupancy rate. pediatrics and there were

(PGH)

is

a

936-bed

Eighty-nine of these 1,844 admissions in 1991.

hospital beds

with

are

for

mean

age

Patients: Pneumonia ranging

is from

significant Death rates (see

a

table

disease I.i

to

of 1.9

ver_ years.

difference in _he ranged from 0-7.9% !).

young

children There

is

with a

a

statistically

age between these two extremes. with the highest rate is the PCGH


15

Resource

Use

Length

of

longest

stay

private

being

just

Again,

by

of

of by

standardized

care was

care

Within

the

same

private

of

biggest

category

No

influence

frequently

in UST

PGH,

had

standardized

tertiary

care

1/6

median

hospitals,

For with

hospitalization private

higher

care,

hospitals,

costs

for

was

total

highest a

(p<0.000)

counterpart

charges

was

higher

o For

always

cost

the more

were

higher

for

43-64%

Costs: of

of the total costs. diagnostic costs and costs.

of

government

of

BFH

with

hospitals.

Categories The

cost

hospitals.

level

stay

of

The

the

the The

hospitals.

PGH.

for

having

hospital.

PGH.

most

private as

PGH

care,

total

the

stay

used

the

associated

same level of care, expensive (p<0.003).

in

of

median

forl tertiary

of

higher

levels

with

government lengths

tests

was

level

of

by

days

of

were

then

6

shorter

length

diagnostic

lower

to

another

have the

and

medications

followed The

of

2.5

PCGH,

tests

PCGH

number

by

hospitals

a third

2) :

from

followed

diagnostic

followed the

table

varied

stay,

three

cost

(see

discernible of

ownership

costs,

The these

therapeutic,

smallest accounted

pattern or

category of form 4-12%

could

levels

of

accounted

be

determined

care.

(See

costs was the of the total regarding

table

3 and

the fig.

9) Acute

Myocardial

Infarction:

The

hospitals

i_

Philippine

included General

2.

University

of

3. Philippine sections treated All

hospitals

Santo

in

Tomas

had

myocardial

years with mean from 2.6 in UST

study

coronary

were

with with

Heart Center separately.

Patients: Acute

the

Hospital

care

139

502

with

the beds

beds both

following: for for

medicine;

pay

patients;

private

and

charity

units. ._

infarction

struck

people

during

ages from 49 to 53 years. to 10.3% in PGH (table 4).

their

Death

productive

rates

ranged


16 Resource

Use

Length

Of

(Table stay

(private). PGH

ranged

Highest

with

33

medications PHC

from

number

lowest

in

was

lowest

for

P729.

maximum

at P5,975 reached up

charity)

because

Charges

were

12.3 of

and

(private)

(private)

5):

the

lowest

in

PGH

at

with

P522

median

occasional

was

days

used

the

of

and

was

PHC

also

in

cost

of

highest

seen

in

!still

lowest

in

for

PHC

in PGH. (private

thrombolytic

highest

in

Median

hi_he_t seen in the PHC

use

P5,696

8.3

20.

_ith

cost

to the P100,000

PGH,

;to tests

(private)

compared to over

of

PGH

diagnostic

PHC

Total

in

The and

therapies.

PHC

(private),

P12,947.

Categories of Costs Most of the costs costs_

Hotel

with

costs

(22-50%).

25%

of

of

the

effect

DISCUSSION There

was

able

to

level

enough

show

of

more

AND

care

costly

mostly

seen

usually

at

the

that

the

acute

variation was

between

Heart

discretion

very

expensive,

as

phenomenon

The

of

General Hospital mean that, being is getting that

the

a

data

the

set

of

level

of

data

care,

to

set,

the

most

of

in

the

PHC

hospital,

and

is

was

are

which

patients

and

is

costs which

consistent

the

was

higher

government

tests

there

Hospital some

drugs,

university

of

which with

physician

cost

General

categories

difference

attending

Despite

pattern

pneumonia

diagnostic

and

costs

contributed

associated

The

infarction hospitals

also

in

discernible

different

costs

same

but

no

therapeutic

share

:

subsidized

thrombolytic in

the

stay'and

Philippine

costs.

the

higher

the

of

(private).

expensive

lowest

The

between

the

Center

is

hospitals. of

myocardial

seen

in

for

length

usually offered at government hospitals.

In

on

by

major

lowest

RECOMMENDATIONS were

for

next

There

descriptors

private

in

the

were

costs."

there

and than

for

costs

the

variation

that

and Table 6): were accounted

accounted

Diagnostic

approximately in the costs.

(figure_ (35-44%)

in

not

is the

enough

contrast

the

Philippine

patients

receiving

(private) PGH,

was

had the

the most

pneumonia.

the

highest

costs

being

seen

at

the

Philippine

may mean that_it is not efficient or may also a government tertiary care referral center, it patients in a more severe state and

inclusion/exclusion

criteria

were

not

stringent


17 enough the

to

ensure

a uniform

different

hospitals.

was

a huge

There

also

thus precluding inclusion/exclusion patterns This

of

care

dataset

by

objective

4.

consistent cannot

be

i.

To

The

and

use

standardize the

of

3.

not

existing the

variance, more

care;

hospitals

role deserve

a

on

be

a

to

hospitalsi

that again, or simply

the that

itself. meaningful

answer

appears

literature for

admitted

within

pneumonia

This

is

but,

robust

of

to

have be

to

to

by

be

itself,

conclusion.

which

patients applied

of university closer study.

of of on

be to

may

be

important

are

expensive

time

in

cost

with

to

added

(20,21)

particularly

collection systems

patients

algorithms

therapy

Prospective

4. The hospitals

allow

world

have

within a small window myocardial infarction;

scoring

even

hosplita_

set

basis

more

validated

standardization illness

costs,

to

This may mean insufficient

the

data

patients

recommended:

thrombolytic

effective an acute

does

provide

are

in

within

specific

the to

decrease

the study Contrasts;

vary

itself

with

following

variation

of

use of means. criteria were

may

The

used

The

2.

the

cohort

data

more entry

versus

the

gain

the

into

adequate

recommended withregard and

natural may

detailed to

entered

to

are

only

history

allow

to

of

better

severity

of

hospital.

non-university

teaching


18

Acknowledgments: The

author

thanks

the

following:

I. the hospitals who agreed to open patients' data to be included in the 2. Drs. Mark Reysio-Cruz and team of co-doctors and senior data

from

patients'

their charts study;

and

allow

their

Jomar Makalinao who supervised a medical students to collect the

charts;

3. Prof. A. Amarillo for the statistical analysis Mike Alba, Jesus Sarol, Cynthia Cordero and Rachel providing statistical advice ; 4. who

Ms. Marie Manalo and Dr. assisted in the generation

Cito Maramba, of tables;

5. the

Philippine funding for

Development

Institute for the study.

research

Studies

and Profs. Delino for

associates,

for

providing


19 REFERENCES: i.

Solon

O,

Financing

Gamboa

in

the

R,

Schwartz

PHilippines.

HFDP

2.

Reagan

Md.

New 3.

England Greer

Journal of Medicine AL. The State of

Physicians

Science:The Diffusion International Journal 1988;4:5-26. 4.

Moller

JT,

Evaluation

of

Mills

Part II. Costs 1990;5:203-218.

The

New

and

England

Compassion:Conflicting

S, Brecher

Espersen

Sector

1992. Challenge.

the

State

of

the

into Practice. in Health Care

et.al.

20,802

Randomized

patients:If. Complications.

EP,

of

Health

Medicine M, for

1989,

Journal

Ii. Harrison DC. American Journal

Policy

1992;

p.

Countries and

Planning

Physicians' in Radiation

327:1497-501.

et.al.

(eds).

Public

Competition

Hospitals.

Michigan.

19-21. the Attending Physician on Costs. Journal of Medical

EJ,

Sakin

Thrombolytic of

JW,

1990.

American

Health

et.al.

Therapy College

Cost

for of

Cost Containment in Medicine: of Cardiology 1985; 56:10C-15C.

G, Grumbach K, Luft Surgery in the United Medical

Association

HS, et.al. States and 1993;

13. Blustein J. High of Service Availability

Technology Cardiac on Service Use

Journal

Medical

the

Developing

Consequences of - Joint Ventures

Henderson Roles

Topol

Infarction. i2:58a-68a.

American

Income.

in

Health Statistics, of Health.

of

12. Anderson Artery Bypass

of

Hospitals

59:789-98.

Philippine Department

of

March,

Complex

K,

in

The Influence of Medical Education

1984;

Steinberg,

of

Press

Implications

the

C,

Administration

8. Jones K. Indirect Graduate

of

A

Postoperative

Journal

Altman

I0.

2.

Health

Technoiogies Assessment

Sunshine JH_. Care Facilities

and

9. Service,

and

Sources

7.

Education

A.

1987;317:1731-4. the Art _ersus

Oximetry

Economics

6. Mitchell JM, Ownership of Health

Health

Monograph

Gatekeepers:

NW,

Pulse

Herrin

1993;78:445-53.

A.

Therapy.

and

New Medical of Technology

Events

Anesthesiology

as

Johannessen

Perioperative 5.

of

JB

American

Association

Intelligence and

Acute

Procedure Myocardial

Cardiology Why

1988;

Cardiology.

Use of Canada.

Coronary Journal

269:1661-6. Procedures: the Impact in New York State. 1993;

270:344-9.


20 14. Udharhelyi IS, Status and Resource Infarction:A

New

Education. 15., Bull

Rosborough Use for

Look

American

at

Journal

Bulla A, Hitze KL. WHO 1978;56:481-98.

16.

Tupasi

T,

Respiratory

de

Tract

Leon

17.

RITM

ARI

Operational

lesson

Program: In

The

The

Health. 20

in

WH0/ARI.

in Metro

the

Philippine

Journal

Medical

ial.

A

Patterns

Reviews

of

a

Acute

Study

of

of

Review. of

A_Longitudinal

Implementation D.

Acute (Eds.)

University Bases

in

Infectious Workshop

an

ARI

on

Control

Internal

Report

the

the for

Infections. Health

Sector

1990

Medicine

Investing

Recommendations

at

Management Acute

1993:

in

1993.

WHO

Children

for

Respiratory Evolving

Press,

for

in

Algorithms of

e_.

Development

Algorithms

Clinical

Graduate

1990;80:I095-II00.

Proceedings

Countries.

of Pneumonia 1991.

Problems:

S,

Teaching Myocardial

Infections:

Manila.

WH

World

Technical

of

Health

Children::

Shepard

Oxford

D.

Lupisan

Mosley

Bank.

Oxford.

Morales

and

and

Public

et.al. Acute

Experienbe.1990.

Developing

World

Management Facilities, 21.

SK

DT

Priorities 19.

ARI

Costs

Respiratory !

Group.

from

Bohol

Stansfield Jamison

of

L, in

Study

Indirect

Acute

Infection

a Depressed Community Diseases 1990;12:940-949.

18.

the

T, Lofgren RP, Patients with

First of

the

Health

Common

Medical

Myocardial 1994;

on

Level

32:51-53.

Infarction.


21

Table

i.

Mean

with

Age

and

Pneumonia

Outcomes by

of

Admissions

Hospital

Hospital

N

Age

+ s.d.

% deaths

3G

164

1.55

+

1.15

4.3

3P

II0

1.89

+

1.33

0.0

2G

165

1.07

+

1.02

7.9

2P

192

1.54

+

1.35

2.6

IP

85

1.73

+

1.38

0.0


"'_1_!,.£

_,,

COMPARISON OF RESOURCE USE FOR PNEUMONIA BY HOSPITAL

3G

3P

2G

2P

1P

160

110

165

192

85

Hotel (days)

6.3 + 4.8

5.0 ._2.4

5.5 32.8

3.0 + 1.4

2.5 + 1.3

Dxtic (tests)

12.0 ± 12.1

2.4 + 1.2

5.1 ±:1.8

4.5 ± 1.6

4.2 ± 1.1

Txtic (P) Range

250 0 - 5186

442 0 - 3861

165 0 - 2478

142 0 - 805

232 50 - 1096

Stand (P) Range

2959 340 - 58,734

2685 604 - 21,050

1818 238 - 10,638

1267 423 - 10,524

929 478 - 2458

Charges (P) Range

2926 340 -58,734

5310 1895 - 28,380

769 233 - 6330

1505 605 - 7920

1591 557 - 5812

'

N


23

Table

3.

Pnellmonia

Median by

Total

Category

By

Costs

for

Hospital

r

Hospital

Hotel

Diagnosti6:

(%) 3G

(%)

0.33

+ 0.17

0.32

+ 0.14

2G

0.49

+ 0.16

0.08

2P

0.37

+ 0.12

0.09

IP

0.43

+ 0.11

3p

,

0.12

Therapeutic

(%) 0.55

+ 0.22

0.64

+

+ 0.04

0.43

+ 0.18

+ 0.06

0.53

+ 0.15

0,.12 + 0.04

0.45

+ 0.10

0 04 +

+ 0,10

0.03

0.16


Table with

4.

Mean

Age

Myocardial

Hospital

and, Outcomes

Infarction

N

by

age

+ sd

3G

107

48.6

+ 10.6

3P

38

51.5

+

•3G

iii

53.4

+

3P

96

53.6

of

Admissions

Hospital

% deaths i0.3

%

9.7

2.6

%

I0.2

6.3

%

+ 10.4

8.3

%


;,is" •l_BZ,e+ 5"- COMPARISONOF RESOURCE USE FOR ACUTE MYOCARDIAL INFARCTION BY HOSPITAL 3G

3G*

3P*

,3P

107

1111

96

38

Hotel (days)

12.3 + 5.6

9.5 :I:3.9

8.3.± 4.9

9.6 ± 5.0

Dxtic (tests)

33.7 + 12.7

23 + .12.2

20 + 8.4

21.3 ± 8.8

Txtic (P) Range

522 73 - 4782

564 0 - 4986

729 0 - 9122

873 0 - 4650

Stand (P) Range

7115 2104 - 15,388

6238 983 - 117,718

5975 825 - 133094.1

6538 820 - 32,575

Charges (P) Range

5696 1522 - 27,690

11,724 1578 .4 117,576

12,947 2920 - 181,827

10,965 3971 - 40,084

N


Table

6.

Median

Myocardial

Infarction

_0spitai

'

Hotel

Total by

Costs Category

Diagnostic

for by

Acute

Hospital

Therapeutic

,.

(%)

(_)

C%).

3G

.40

+

.ii

.25

+

.Ii

.35

+

.16

3G*

.28

+

.ll

.22

+

.12

.50

+

19

3P*

.37

+

.14

.25

+

.13

.38

+

.30

JP

.30 +

.18

.26

+..19

.44

+

.27


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.( -I -i -1 +,

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(;(_st. of illness Avute NyooardJa/ I l)tlt'J :, l"'l'P+kl'fF,: llC):gP] 'l"AI........................ ,(;IIAIITIIU : AGE (years): I)ATEADH : I)ATEIil .St:ll : II I AGtI(,),S1o": I. i.ypjca.l, r-llesl, paJtl 2. 2x illt':rease i,i ,-.nzymes 3. evo luLio_,at'y I_(:G t)TIIERL)X t : I. EA]II/IIA._ ¢oode: 1 :: Yes, )

Is

__ __ '-0 = No) DXI

I_KG (JXR ,6gri t-BS/EBS UI+.LC _C]TD C

'l ,.flaP']

BIJ I'l

CR CA P IIA It CfIOL T+; AHYLA+;}'7 ..... 2-1) e,- li,) _4/o 2.-1)_

,++

,'1

I)X'l'J C. lJXJ CBC t' I,ATEI, L.:T I,_SR O(;(:UI,T UIRINALYS/S__

_>('}l,+. .)

._ _

.,<'Lr_,._s LesL Otllersl 'I'XTI C AIIAI,/PYRET I C,S fiI,LIII':WI'AI1Y C VS/l) i lJ IIg'l' tCS RF,SP I Rk'l'O RY

I:orn, ]zlfaretion

1

SGO'I' LOll CPK-HB C,PK k I I_Phos IlL)f, I,l)[, 'I'YI+,I, ll(, IIA'I'Cll

I4/

fig

_ _

'l'l_a tlium OLiver,2

Dl kGfltJSl L_1 ...............

....

O'i'llI(lll_X

.........

I'I l'3.I ROll IJ SC:i.II ,k t/ IIO Ill iUtl Ig$/(J(' P ll{l"

MI'I' J.I+,> J O'l' I ¢.a O'l'llJi [( C.IIl,:tlO (;l,]tf.['l'OIl R/llAllY H_'f'ABtJL r SIt V 1T/li 1:I:I -[II/'I'R TT fOPl F+YE/F,AI_ Hf)WI'II/TII flOAT DF,till A VAC.,I (, Ill+,./;-;EIIA :e,

................

...........

z+-_ .........

.........

...............

_

..........


[ VI' I_W1")) I"I!B(; O'I'I[_[(S

._ ......

-

SIlPFLIES '.I VT _ _ tlc)T FC 02( 10<)0 [,iLel'._) )

O'I'llg_S

5peci l'_

I" i'o_:erl)I

f'y

:

At)giot_,lasl.y ._ _ TP I .... PP]. _. _ ,_;I,)'el._I.r, lc izta:;(: 'I'I,A _.. ("AI_G .... II()_';I'I'I'AI, l':ll I ,",11 WAI+I)

I)AYL')

I)I F,','I'IIAY[.; II YF_I;:F'A I'I)A Y"; ()FI)AY',_ It l I,KI)AY:: Itl,:ril)A Y" :_l'l,:(' IAI,I)AY_; Ill'(),,:l,':,a l i,I I) ,l

,',))11'1,

I

::1 ..... i l' y

:f)IIIII':IIT:; :


Cost of lllI,ess Form Pn eu mon ia ID[IO: PT[iAIIE: HOSPITAL : CHARTNO : AGE _years): DATEADII: _ _ - _ _ - _ _ DATEDISCH: - _ - _ - - - _ DIAGNOSIS: i. _ough 2. RR>50/min 3. chest indrawing_ OTHERDXI : DEATH/HAA (Code: i = Yes, 0 = No) DXTIC DXI CBC _ _ HB/H _1 PLATELET _ _ ESR _ _ FECALYSlS _ _ OCCULT URINALYSIS__ BUll _ _ CR NA K _ _ CL. __ TXTIC ANAL/PYRETICS ALIMENTARY CVS/DIURETICS RESPI RA'rORY NEUROHUSCULAR HORMONES/OCF ANTIBIOTICS OTHER CHEHO O'ENITOU RINA RY METABOLISM ViT/MIN NUTRITION EYE/EAR [_OUTII/TII [{OAT DEI!MA VACC IN ES/,_I., RA IVF ' FWB ,

PRBC OTHERS SUPPLIES IVT

sputum ,G/S sputum C/S .ABG _ _ CXR F/RBS- blood c/s aspirate g/s aspirate-c/s OTHERSI OT[IE[IS2 OXIHETRY __ __

DIAGNOSIS1

_ _

__

OTI{ERDX

__

.:-


NGT FC

__

02(I000 OTHERS

Liters) Specify

i

HOS?ITAL ER ICU WARD

DAYS _ _

RESPIRATOR STEAH NEBULE PT

_ _ __

P_OCEDI PRDCED2

....

DIETDAYS }{YPERALDAYS OFDAYS MII,KDAYS REGDAYS SPECIALDAYS tlPO/clearliq

D

__

OUTCOIIE _'.-, (code: COHPLI Specify:

O=,lone, II if present,

9-not

evaluable)

CO Mt'lEI'VI'S :

Dat._:

RA: ¢

.... ._ _


GUIDELI[IES _: _"UT AS'I'E_.JSK AT UFPER . (4tlESTLUtlS RI_GAI_.DIItG DATA IN *

Costs

will.

be

expressed

IN

COSTILIG

LEFT }IAItD CURNBR 'FILE FORH. in

1994

1F

'l'llBRli

AHE

pesos.

Diag_os_s ,.,f AIII depends on: presence of 2 ,mr of tile following: -crushing che._t pain, retrosternal, >[5 rain, witlt diaphoresis -CPK-HB elevated >2x normal within first 24 l,ours -Evolutionary F,KG changes (on at least 2 }:CGs) - development wave, ST elev:_tion, 't'wave inversion. *

l)ata to be collected: diagnostic - units of use therapeutic (including pr'oeedures) of drugs by diagnosis

, Ij._eof If you can't data colleeLion * of

,g99 vs 0 as say, code _orm.

* for all contai_lers e,l.c Ii da.y.

_irst

IV drugs and additives; as 24 hours only. will

* if amount consumed in terms of smallest prepat-ation should be used not a fraction thereof. ['or P't'sessions,

count

- cost

code. 'if definitely as 999. Do not leave

for all U'I'tlF,_S, ,;ode others in times jn the last t_o blanks.

number

being used (not just exercises; under others in. therapeutics. inhalation, nebulization, etc.

SUIII;;

of

two

consider have to

medicines/group

blanks

shelf include

and

the

number

life of opened a new oust for

is very at its

small, the unit price,

l.f instruments

are

e.g, ultrasound), note and put This is also the case with steam

* Code for procedure: I - CVP insertion 2 - traeheosto,,y 9 -.others:specify *

For

....

IVF :

!JSE I/0 charting as ['irst source of data If no i/0 charting: use 1 liter/day if on regulartiiet/OF/HYPERAL, use 3 liters/day if on _IPO [IOTE: if renal or oa_'diac patient: use'order _IO'fE.:a lack of precision within the order acceptable.

q

not done, code as O. any blanks in the

mg or ml but costed

sessions,

of

of

sheet. of 250

ml

is

still


-*. For FC, check if present (FC) in vital signs sheet, assume 1 FC per HDs *, If with IVF, impute one set of IVT per 7 HDs. .*. .for 02 : imputeonly at 2-3 litees/min (unless specified in orders) for hour s.

* For hospital days: Round off to lo_rer number or equal to 12 hours.

if < 12 hours

and

*. for diet: clear liquids, code as [IFO soft diet, ¢or.leas regular diet low diet, code as regular diet • high diet, code as special diet ].f out on pass, code as ['I_0 "i: for CoiJirlg _:,fmeal days, should have same kind to be coded as such. * Clreck ord,_r_ ollly for: 1. _nitial order for.lVF 2. initial order for U2 3. orders .fr,_, biopsies and procedures 4. PT sessiolls/radiotl|erapy and other i

at

7

4

to liigher nulnber if >

least

ancillary

2 meals

procedures.

of

tile


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